Risk/Benefit Communication about Food—A Systematic Review of the Literature

Figures & data

Table 1 Examples of different types of potential food hazards classified according to whether or not they have been deliberately or accidentally introduced into the food chain, or are naturally occurring, and whether they represent acute or chronic risks. Please note that this table is not intended to be inclusive, and the examples provided are illustrative only.

	Instrumental change results in introduction of potential food hazard into the human food chain		Accidental introduction of potential food hazard into the human food chain		Naturally occurring potential food hazards
	Consequences potentially negative	Consequences negative and/or positive	Consequences potentially negative	Consequences potentially negative and positive	Consequences potentially negative	Consequences potentially negative and positive
Acute	Negative impacts may be the consequence of deliberate and unintended introductions	Consumer behaviors directed toward one societally approved outcome may accidentally introduce increased risks	Food hazards frequently presented in a “crisis” context and as such specific incidents are less easy to predict	Introduction of novel foods may increase nutrition levels while simultaneously introducing risks	Microbiological contamination “outbreak” or microbiological contamination incident	Foods may be associated both risks and benefits associated with nutrients or other food constituents
	Deliberate introduction of hazard	-Consumers may use microbiologically contaminated foods leftover to reduce household food waste	-Dioxin food chain contamination incidents (Belgium, Germany, Ireland, etc.)	-The introduction of meat substitutes such as insect proteins may not only have beneficial impacts on the environment (reduced meat production resulting in more efficiencies in the production chain) and improved consumer health (reduced fat intake) but also have negative consequences (environmental impacts following environmental escape of farmed animals or introduction of novel allergens, unintended exposure to existing allergens)	-Salmonella, Campylobacter, E-coli O157H7 outbreaks associated with specific food outlets	-Natural toxins, e.g., kidney beans containing naturally a toxin known as phytohaemagglutinin if inappropriately prepared
	- Melamine contamination of milk powder (deliberate fraud)	-Increased production of biofuels increases food prices with concomitant impacts on food safety as consumers use food which has passed its best-before ate	-Radioactive contamination of foods (Chernobyl, Fukoshima)		-Microbiological contamination of foods associated with domestic hygiene practices
	-Horse meat in beef meat (adulteration)	-Consumer requirement for “minimally processed foods,” promotion of “sous-vide” foods (mild treatment)	-Guargum contamination		-Listeria monocytogenes outbreaks (cheese made of unpasteurized milk, pate)
Chronic	Negative impacts may be presented in a crisis context, but represent a “chronic” risk in terms of duration and associated mitigation strategies	Negative consequences may also include negative consumer responses, independent of technical risk assessments. Ethical objections may also be raised	Unintentional use of hazardous ingredient instead of a safe equivalent	Food associated with health promotion introduces additional risks to potentially vulnerable groups	Emerging hazards may result as a consequence of concomitant external changes	Foods may increase both risks and benefits associated with long-term nutrient intake
	Unintended introduction of hazard	-Food irradiation, pesticides used in food production, -nanotechnology used in food packaging	-Illicium anisatum (Japanese star anise) used in error instead of Illicium verum (Chinese star anise)	-Methyl mercury contamination of fish (consumption simultaneously associated with increased omega three fatty acids)	-Mycotoxins (due to lack of Good Agricultural Practice) and their emerging occurrence (e.g., as a consequence of climate change)	-Seaweed represents a “novel” food for many Europeans. Seaweed consumption may introduce increase consumption of iodine to deficient populations, but increase salt consumption to unacceptable levels
	-BSE in cattle and new variant CJD in humans mitigated over a time period	-Use of artificial food additives		-Food allergies/allergic foods (e.g., kiwi)
	Deliberate introduction of hazard	-Animal cloning for food supply		-Milk for babies
	-Methanol in wine to improve organopleptic properties	-Genetic modification of plants and animals
		-GMOs
		Other risks may arise as a consequence of inappropriate consumption
		-Use and misuse of some functional ingredients or enriched foods (for example, high intake of foods enriched with some vitamins)
		-Fortification of foods with vitamins/micronutrients (risk of overdose especially in case of regular consumption of food supplements)
Chronic risk presented as a “crisis” in light of new scientific knowledge or increase in societal concern	Negative impacts may be presented in a crisis context, but represent a “chronic” risk in terms of duration and associated mitigation strategies	Often related to the introduction of controversial existing or emerging food technologies, where new research regarding putative risks and/or benefits are associated with extensive media attention	Increasing evidence base results in policy responses or media dissemination of information	Novel risk assessment methodologies highlight “new risks” associated with potential hazards previously thought to be safe	Increased understanding of toxicology may identify “new” food risks	Foods continually associated with different reports of risks and benefits
	-BSE in cattle and new variant CJD in humans -Acrylamide in baked products	-Genetic modification of food crops and animals for food products, pesticide application to food crops	-Antibiotic use as growth promoters in animal and fish farming may be associated with increase of antibiotic resistant strains of pathogens	-Pesticide residues on fruit and vegetables	-Differential vulnerabilities to toxic substances across the population may require targeted risk communication strategies	-Red wine consumption has variously been reported as having beneficial health effects (e.g., on cardiovascular system) as well as negative health effects related to alcohol content
	-Transfats used in food processing			-Chemicals migrating onto food from food packaging		-Debate about Meat consumption (vegetarian vs. paleolithic diets in evolutionary psychologu)
	-Certain applications of nanotechnology in food processing			-(Certain) Food colorants

Table 2 Final search string applied in the search

TITLE-ABS-KEY
Search term 1 (AND)
(food* or agri* or agro*)
Search term 2 (AND)
(risk*)
Search term 3 (AND)
(public or consumer* or citizen or lay or individual)
Search term 4 (AND)
(attitude* or percept* or accept* or opinion* or view*)
Search term 5 (AND)
(communicate* or dialogue)
AND
Peer reviewed and English language

Table 3 Rapid evaluation screening criteria

Decision questions	Coding decision
Is the abstract primarily focused on research on food and agriculture? If no then exclude.	Excluded N = 79
Is the abstract reporting research that deals with risks associated with food/agriculture? If no then exclude.	Excluded N = 12
Is the abstract reporting research that focuses on the communication of food/agriculture risks to the general public?	Excluded N = 68
Not sufficient detail to answer questions above	Excluded N = 4

Table 4 Assessment of risk perceptions, benefit perceptions, and both risk and benefit perceptions with time

	Year of publication
What was assessed in terms of risk and benefit perception	1990–1996	1997–2001	2002–2006	2007–2011
No risk or benefit perception assessed	5	2	6	13
	71.43%	33.33%	37.50%	52.00%
Only risk perception assessed	1	2	6	9
	14.29%	33.33%	37.50%	36.00%
Risk and benefit perception assessed	1	2	4	3
	14.29%	33.33%	25.00%	12.00%

Table 5 Measured outcomes against stated aim of paper. For the shaded cells, the outcome measure is not directly linked to the intended effect of the communication intervention

Outcome measure reported: Effect of communication aimed at change in:	Risk perception	Attitude	Behavioral intention	Risk and benefit perception	Risk perception and attitude	Risk perception and behavioral intention	Risk perception and benefit perception and attitude	Risk perception and benefit perception and behavioral intention	Risk perception and attitude and behavioral intention	Risk perception and benefit perception and attitude and behavioral intention	Attitude and behavioral intention	Total
Cognitive impact/attitude	5	2	1	2	0	0	3	1	0	0	1	15
Intention	1	0	2	0	0	0	0	0	0	0	0	3
Behavior	1	0	0	0	0	1	0	0	0	0	0	2
Cognitive impact/attitude and intention	1	0	3	0	1	3	1	0	1	1	0	11
Cognitive impact/attitude and behavior	1	0	0	0	0	1	0	0	0	0	0	2
Cognitive impact/attitude and intention and behavior	0	0	0	1	0	0	0	0	0	0	0	1
Total	9	2	6	3	1	5	4	1	1	1	1	34

Table 6 Variation in information qualities and participant characteristics

Information variations	N
Type of risk	4
Framing	6
Source	6
Order of arguments	3
Quantity of information	3
Type of information	5
Information format	2
Participant characteristics
Sample demographics	2
Prior attitude	2
Motivation	1

Table 7a Results concerning target characteristics

Article	Results concerning “Target Characteristics”
Aizakia, Nakashima, Ujiie, Takeshita, & Taharae, 2011	Consumers who are interested in, and enquiring about, risk information are more likely to access food risk information.
Angulo & Gil, 2007	Higher education levels are related to higher confidence in food safety and lower risk perception.
Chipman, Kendall, Slater, & Auld, 1996	Different media have different effects according to audience differences in concern level prior to communication.
Derrick, Miller, & Andrews, 2008	Risk communication can improve knowledge and influence behavior change appropriately for specific behaviors and vulnerable groups.
Figuié & Fournier, 2008	Public confidence in their own risk avoidance strategies can be an obstacle to introducing new practices in risk communication.
Fisher & Chen, 1996	People are more satisfied with risk information about things in which they are primarily interested in.
Frewer, Howard, & Shepherd, 1998	Initial attitude was the most important determinant of postcommunication attitude. Also, admitting risk uncertainty increased acceptance of technology communicated about.
Frewer, Scholderer, & Bredahl, 2003	Prior attitude is the dominant predictor of post information risk/benefit perception and attitude. Trust follows from prior attitude and does not influence post information attitude or RP or BP.
Glik, Drury, Cavanaugh, & Shoaf, 2008	Misinterpretation of key words and concepts by the public can make communication materials ineffective. When new knowledge is presented, it must be compatible with what people already know and how it is organized before it can be assimilated into memory.
Hughner, Maher, Childs, & Nganje, 2009	The provision of advisory information about a food product has a differential impact on different population groups. Groups that have been assessed to be not at risk are most likely to discard information.
Kim & Paek, 2009	Level of motivation plays a role in heuristic and systematic processing of information on risks (and benefits), affecting extent of attitude change.
Kjærnes, 2006	Different nationalities have differing levels of trust in food. Social/demographic variables have only limited impact apart from gender where women were found to be more skeptical and distrustful than men.
Koç & Ceylan, 2009	The purchasing habits of consumers can change differentially for different socioeconomic parameters (age, employment, education, and sex) as a result of the provision of risk information from various sources in various formats.
Kuttschreuter, 2006	An individual who is actively trying to avoid a risk will seek out more information about that risk and this process of seeking information influences their perceptions of, and affective responses to, a risk.
Meijnders, Midden, Olofsson, Öhman, Matthes, Bondarenko, & Rusanen, 2009	A source of information was considered more trustworthy if expressed attitudes were congruent with those of the person(s) receiving the information.
O’Neil, Elias, & Yassi, 1997	Risk Communication outputs must be sensitive to cultural and public health values as well as scientific output.
Shimshack, Ward, & Beatty, 2007	Information-based initiatives can be effective by reducing expenditure on and consumption of risky products amongst a targeted at risk group. However, not the whole target population may be reached while nontarget population may act on the communication not intended for them.
Tucker, Whaley, & Sharp, 2006	Food safety risk perceptions, in particular towards biotechnology, are elevated as media dependency (attachment to mass media) increases.
van Dijk, Houghton, van Kleef, van der Lans, Rowe, & Frewer, 2008	There are cross-cultural (national) differences in interpretation of risk communication messages.
Vardeman & Aldoory, 2008	Contradictory health communications analyzed in several ways, such as filtering information against prior beliefs, and influenced by personal situation (e.g., pregnant women focus more on health risk than benefit communication compared to others).
Verbeke & Van Kenhove, 2002	Increased need for information and higher importance of risk information associated with lower emotional stability during crisis.
Verbeke, Vanhonacker, Frewer, Sioen, De Henauw, & Van Camp, 2008	Differential impact of risk, benefit, and balanced information (on perceptions of attributes and behavioral intention), that may have been mediated by initial perceptions of the topic communicated about (here, positive).

Table 7b Results concerning the nature of information

Article	Results concerning “Nature of Information”
Batrinou, Dimitriou, Liatsos, & Pletsa, 2005	Relevant information can lead to more positive attitudes about the acceptability of a technological innovation.
Blanchemanche, Marette, Roosen, & Verger, 2010	Conflicting risk and benefit information confuses people and leads them to resort to habitual food choices.
Bord & O’Connor, 1990	Information type has differential impact on attitudes to a novel food technology: technical information had less impact than nontechnical concerning history of (safe) usage and prestigious endorsers.
Chipman, Kendall, Slater, & Auld, 1996	Different media have different effects according to audience differences in concern level prior to communication.
Connelly & Knuth, 1998	Multiple information formats are best at communicating information. Also, a cajoling rather than commanding tone is better at communicating information.
Feng, Keller, Wang, & Wang, 2010	Risk communication can improve knowledge and influence behavior change appropriately for specific behaviors and vulnerable groups.
Fischer & Frewer, 2009	Certain characteristics of information appear to lead to increased attention, notably, risk information over benefit information; information on unfamiliar as opposed to familiar products; and information presented first.
Fleming, Thorson, & Zhang, 2006	Different media channels, used for the provision of risk information, may result in different selection and usage of a certain information-processing strategy (e.g., elaboration more likely when reading a newspaper story than when watching TV) by the public.
Frewer, Howard, Hedderley, & Shepherd, 1997	Credibility of source related to risk perception, but mediated by factors such as perceived hazard characteristics and information content.
Frewer, Miles, Brennan, Kuznesof, Ness, & Ritson, 2002	Uncertainty with the scientific process of risk management is more accepted (in communications) than uncertainty due to lack of action or lack of interest on the part of the government.
Knuth, Connelly, Sheeshka, & Patterson, 2003	Order in communication affects preferences, specifically, asking about risk first increases risk perceptions; asking about benefits first increases benefits perceptions.
Koç & Ceylan, 2009	The purchasing habits of consumers can change differentially for different socioeconomic parameters (age, employment, education, and sex) as a result of the provision of risk information from various sources in various formats.
Miles & Frewer, 2003	People respond to different types of uncertainty in a similar way. Optimistic bias demonstrated regarding likelihood of personal risk versus risk to others after risk communication.
Nauta, Fischer, Van Asselt, De Jong, Frewer, & De Jonge, 2008	As people receive information about food safety, their motivation to adopt safer food preparation practices increases. Actual behavior change requires communication at the moment of the behavior.
Ogoshi, Yasunaga, Obana, Ogawa, & Imamura, 2010	More information leads to lower anxiety.
Park & Lee, 2003	Framing a technology in different ways influences benefit perception (Genetic engineering more positive than Genetic modification or Biotechnology) and risk perception (Genetic engineering lowest, than Biotech, Gen Mod most risky), but no differences on uncertainty, attitude or purchase intention.
Qin & Brown, 2006	Process related consequences (on molecular level, fish fertility, and ethical cultural consequences) and product consequences (business impact, benefits to food system, improved regulation requirement, consumer choice, and ecosystem) raised demand for labeling and information and multiple stakeholders acting in consensus.
Rodriguez, 2007	Provision of information on a food technology results in receivers being initially less favorable about a technology, perceiving it as more of a safety risk than those who received no information.
Sapp & Korsching, 2004	The effect of negative information can be reduced over time by positive endorsements by opinion leaders suggesting that confidence in social institutions may influence public adoption of a food technology/product.
Saulo & Moskowitz, 2011	Food safety messages were not found to increase consumers’ willingness to pay a premium for safer food.
Siegrist & Cvetkovich, 2001	Certain information is more trusted—notably, information indicating health risks versus information not indicating health risks (independent of trust in source).
Singer, Williams, Ridges, Murray, & McMahon, 2006	Presenting a short health statement on the front of package is trusted more if more comprehensive data is printed at the back of pack.
Sparks, Shepherd, & Frewer, 1994	Framing of a technology by selecting specific expressions has an effect on how favorably the public responds to that technology.
van Dijk, Fischer, & Frewer, 2011	Using QALYS to communicate risk/benefit information may useful though it is format and situation dependent.
van Kleef, Ueland, Theodoridis, Rowe, Pfenning, Houghton, & Frewer, 2009	Preferred characteristics of communications about risk management include: proactive (over reactive); prompt communication about novel hazards; messages on stringent enforcement. Trust relates to perceptions that public health is prioritized and risk manager have no vested interests. Uncertainty has no negative impact on source trust but may be a cause for alarm in itself
Vardeman & Aldoory, 2008	Contradictory health communications analyzed in several ways, such as filtering information against prior beliefs, and influenced by personal situation (e.g., pregnant women focus more on health risk than benefit communication compared to others).
Verbeke, Vanhonacker, Frewer, Sioen, De Henauw, & Van Camp, 2008	Differential impact of risk, benefit, and balanced information (on perceptions of attributes and behavioral intention), that may have been mediated by initial perceptions of the topic communicated about (here, positive).

Table 7c Results concerning characteristics of information sources

Article	Results concerning “Characteristics of Information Sources”
Dean & Shepherd, 2007	Conflict and consensus between sources in a communication can affect public perceptions of risks differentially.
Frewer, Howard, Hedderley, & Shepherd, 1997	Credibility of source related to risk perception, but mediated by factors such as perceived hazard characteristics and information content.
Frewer, Howard, Hedderley, & Shepherd, 1996	Different information sources are associated with different characteristics (accuracy; knowledgeable; past history; level of concern for public welfare) and these influences how differentially trusted a source is by the public.
Meijnders, Midden, Olofsson, Öhman, Matthes, Bondarenko, & Rusanen, 2009	A source of information was considered more trustworthy if expressed attitudes were congruent with those of the person(s) receiving the information.
Redmond & Griffith, 2005	Rank order of preferred source: (1) packaging, (2) doctor, (3) leaflet, (4) TV documentary, (5) recipe, (6) TV cooking show, (7) magazines, (8) posters, (9) TV other, (10) radio, (11) family, (12) friends, (13) school, (14) fridge magnets, and (15) printed towels.
Sapp & Korsching, 2004	The effect of negative information can be reduced over time by positive endorsements by opinion leaders suggesting that confidence in social institutions may influence public adoption of a food technology/product.
Velicer & Knuth, 1994	Newspapers and Regulatory Guides are important sources of information for opinion leaders and specific groups of individuals. These groups were stimulated by such information to engage in risk reducing behaviors.

Table 8 Recommendations for future research by year of publication

	Year of publication of paper
Recommendation for future research	1990–1996	1997–2001	2002–2006	2007–2011
None	4	3	3	8
	66.70%	50.00%	21.40%	36.40%
Theoretical innovation needed	1	0	1	0
	16.70%	0.00%	7.10%	0.00%
Utility of information/ how useful is content?	0	1	0	1
	0.00%	16.70%	0.00%	4.50%
Trust in information source	0	1	4	0
	0.00%	16.70%	28.60%	0.00%
How do you assess impact on behavior?	0	0	0	1
	0.00%	0.00%	0.00%	4.50%
Communicating uncertainty	0	0	1	2
	0.00%	0.00%	7.10%	9.10%
Longitudinal analysis (crisis /noncrisis)	0	0	1	3
	0.00%	0.00%	7.10%	13.60%
Long term effects on perceptions/behavior	1	0	1	2
	16.70%	0.00%	7.10%	9.10%
Media as a communication channel	0	0	1	0
	0.00%	0.00%	7.10%	0.00%
Interactive studies in complex systems	0	0	1	1
	0.00%	0.00%	7.10%	4.50%
Individual differences	0	1	1	4
	0.00%	16.70%	7.10%	18.20%

Table 9 Recommendations in best practice for risk communication about food by time

	Year of publication
Risk communication recommendation	1990–1996	1997–2001	2002–2006	2007–2011
Use balanced and transparent risk (benefit) information when structuring communication	2	0	2	5
	40.0%	.0%	25.0%	45.5%
Base communication on prior knowledge of what consumers do including habitual behaviors	2	0	2	2
	40.0%	.0%	25.0%	18.2%
Address alternative value systems as part of communication	0	0	1	0
	.0%	.0%	12.5%	.0%
Communicators need to understand both technical and perceptual risk characteristics	0	1	1	0
	.0%	50.0%	12.5%	.0%
Be proactive with the public, i.e., communicate as soon as an emerging or new risk is identified	0	0	1	1
	.0%	.0%	12.5%	9.1%
Use multiple/appropriate communication channels to reach target audiences	0	1	0	0
	.0%	50.0%	.0%	.0%
Target risk communication to (e.g.) vulnerable groups or other relevant message recipients	1	0	1	0
	20.0%	.0%	12.5%	.0%
Communicate concrete and actionable risk reduction measures which individuals can take	0	0	0	2
	.0%	.0%	.0%	18.2%
Consider the role of trust in information source and/or information channel	0	0	0	1
	.0%	.0%	.0%	9.1%

Knuth, B. A., Connelly, N. A., Sheeshka, J. and Patterson, J. (2003). Weighing health benefit and health risk information when consuming sport-caught fish. Risk Anal. 23(6):1185–1197.

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