Content. Research Rationale. Perceptions, Attitudes and Understanding of Health Claims on Milk for Children among the Indonesian Mothers

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Perceptions, Attitudes and Understanding of Health Claims on Milk for Children among the Indonesian Mothers Ms Karin Tan PhD Candidate Newcastle University (Singapore) Why Who & How Results Next Steps Content Background Aim and Objectives Subjects Method Findings Conclusion Recommendation 1 2 What is health claim? Codex Alimentarius (CAC/GL 23-1997) defines Health claim means any representation that states, suggests, or implies that a relationship exists between a food or a constituent of that food and health. Research Rationale Health Claim Nutrient Function Claims Other Function Claims Reduction of Disease Risk claim e.g. Calcium plays a role in the formation and maintenance of bone density and teeth. e.g. Soluble dietary fiber (Psyllium, beta glucan from oats, inulin from chicory and pectin from fruit) can help maintain / preserve the function of the digestive tract. e.g. Consumption of adequate calcium at an early stage can help slow the occurrence of osteoporosis in the future if accompanied by regular physical exercise and consumption of balanced nutrition. 3 4

Aim and objectives Aim: Investigate the Indonesian mothers understanding of health claims and the impact of the regulatory framework Objectives: Conduct Focus Group Discussions to Investigate the status of the Indonesian mothers current understanding of health claim Identify the mothers current knowledge and trust of the regulatory process and framework Subjects and Method Study: 3 countries (Focus on Indonesia today) 5 6 Subjects ü Current users of Milk formula for Children (>3 years old) mix of different brand users ü Mothers (each with a child aged 3 6 years old) ü Of average socio-economic status ü Mid-level educated Method Two focus group discussions were conducted in March 2015 in Bahasa Indonesia. Each focus group discussion had eight subjects and each lasted two hours. An independent market research agency specialising in consumer research, was engaged to execute the focus group discussions. ü Live in Jakarta (Urban) ü Make a point to read food labels including nutrient and health claims when purchasing food/ beverages for their children 7 8

The findings... Indonesian mothers see health claims as a description of the product benefits Indonesian mothers do read the product labels, prior to their purchase From reading the product labels, they seek to obtain more information of the product benefits i.e. what can the product do for my child? They tend to pay more attention to the product labels in their first brand purchase Thereafter, mothers generally assume that the product labels are the same as per their first purchase; unless there is a change in product packaging We know about the health benefits from the product s nutritional value, so we would know it is beneficial for our child s immunity, brain, and bone. 9 10 How do the mothers understand the purpose of health claims from the different perspectives? Because we didn t know or understand before. For laypeople, they don t know what AHA and DHA are for so this makes it clear. From the manufacturers: - Differentiate from their other products - A commitment to provide healthier, better products It gives us things to consider so we can compare it among several products before deciding which products to buy. Manufacturers Mum From the mothers: - Provide knowledge on the product/ ingredient benefits - Help them to make decision on their food choices for their child From the local authority: - Manufacturers are one of the Authority working partners on health claims. So there is a strong connectivity between two sides ie. Producer and BPOM. List of common nutrients and their health claims which the mothers could recall Calcium Most knew that calcium is good for bones Some had the perception that calcium would make their child grow tall Iron Some mentioned that it would be good for blood Only few spontaneously mentioned the benefits for hemoglobin which supports oxygen circulation Few thought it might be for teeth and bones DHA, AHA, Omega 3 Known as good for brain development Believed to help make the children smart and active Prebiotic Might get confused with probiotic Known as good for digestion and immune system Zinc Not sure of the function some thought it was good for bones or blood cells Vitamin A Less familiar with Vitamin A Known as good for eyes Vitamin B1-12 Were able to mention term but did not know the function of these vitamins Note: The bigger circle, the higher awareness of the health claim 11 12 12

Awareness of claims are largely driven by mothers knowledge of the nutrient Do these Indonesian mothers trust health claims? In general, Indonesian mothers trust health claims as stated on the product packaging. Trust in health claims is established through mothers trust of International Brand manufacturers and the government. They may not be able to recall the government regulation system but they do have the perception that the government is working with the manufacturers to provide accurate and truthful information and that the product is safe for consumption. 14 13 14 Knowledge and trust of the regulatory process and framework Mothers believed that there is a regulatory body which is in charge of ensuring product quality, the BPOM. They were uncertain if there is an organization which regulates health claims. Few felt that there might be a government organization which regulates health claims. Mothers believed that the role of such a governing body is to verify if the nutritional value mentioned on the packaging is correct. As the claim is based on the creativity of the producer, BPOM is more responsible regarding the content and should check whether the content of milk meets with the nutritional facts stated on the pack so it won t danger the health. What happens when the mothers don t understand the health claims? - Product label is one source of information to the mothers to get to know some nutrients and their benefits. - Some mothers would also try to find more information from internet using search engine or online forums or even ask the doctor to validate to get a full picture on some specific nutrients. Because they will consume it and the intake will be digested in their body, I can t just play trial and error. When there s something unclear, we would Google it. For example, we didn t know what s the function of DHA, ARA until we searched on the internet. 15 16

Whose responsibility is it to educate health claim? Both the government and the manufacturers have key roles to play here. The Indonesian mothers felt that the role of health claims is also to educate consumers on the ingredients. Though satisfied, Indonesian mothers would like to see improvements with current health claims Beyond product differentiation, Indonesian mothers also saw health claims as an educational tool to better understand their child s nutritional needs. The mothers claimed that they knew vitamins. In fact they probably just knew them by name with no clear picture on the full understanding of the nutritional and health benefits. This is an area in which both the government and the manufacturers could play significant roles. 18 17 18 Conclusions Indonesian mothers perceived the purpose of health claims was to provide knowledge on the ingredient benefits and to help them to make decisions on their food choices. My Recommendation Schools, books, doctors, internet and the information from the manufacturers (food labels and advertising) are their key sources of information. The mothers believed the health claims from the International brands and they trust the government. 1. Why is there that level of trust in Indonesia? 2. Why is there that level of trust in the ASEAN? Mothers have the perception that the government is also working with the manufacturers to provide accurate and truthful information. Public Public Private Partnership Private Both the government and the manufacturer are viewed by the mothers as playing key roles in education about health claims. 19 20

Terima Kesih This independent research is supported by the Singapore Economic Development Board and an unrestricted scholarship from Danone. For more information, email: k.tan@ncl.ac.uk 21