Association of front-of-package warning label perceptions with Mediterranean diet adherence after bariatric surgery

Background: Front-of-package (FOP) warning labels are intended to support healthier food choices; however, evidence on how patients perceive these warnings after bariatric surgery and how such perceptions relate to dietary quality is limited. We examined the association between perceptions of FOP wa...

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Autores principales: Laboriano Milián, Sila Maribel, Palomino Ruiz, Lesly Pamela, Morales Garcia, Wilter Charming, Calizaya Milla, Yaquelin Eveling
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Publicado: 2026
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author Laboriano Milián, Sila Maribel
Palomino Ruiz, Lesly Pamela
Morales Garcia, Wilter Charming
Calizaya Milla, Yaquelin Eveling
author_browse Calizaya Milla, Yaquelin Eveling
Laboriano Milián, Sila Maribel
Morales Garcia, Wilter Charming
Palomino Ruiz, Lesly Pamela
author_facet Laboriano Milián, Sila Maribel
Palomino Ruiz, Lesly Pamela
Morales Garcia, Wilter Charming
Calizaya Milla, Yaquelin Eveling
author_sort Laboriano Milián, Sila Maribel
collection Producción científica
description Background: Front-of-package (FOP) warning labels are intended to support healthier food choices; however, evidence on how patients perceive these warnings after bariatric surgery and how such perceptions relate to dietary quality is limited. We examined the association between perceptions of FOP warning labels and Mediterranean diet (MedDiet) adherence among adults after bariatric surgery in Lima, Peru. Methods: This was an observational, analytical, cross-sectional study of 200 adults (18-59 years) attending postoperative follow-up at a private clinic in Lima, Peru. MedDiet adherence was assessed using the KIDMED index (originally developed for children/adolescents and used here as a proxy measure of MedDiet-aligned behaviors), and perceptions/understanding of FOP octagonal warnings were measured using a previously validated Peruvian questionnaire. Associations were evaluated using bivariate analyses and multivariable logistic regression, reporting adjusted odds ratios (aOR) and 95% confidence intervals (CI). Results: In adjusted models, higher self-reported preference for salty foods (aOR = 0.261; 95% CI: 0.136-0.501) and sweet foods (aOR = 0.490; 95% CI: 0.263-0.913) were associated with lower odds of medium/high MedDiet adherence. Greater agreement with the statement "I would follow the octagons, but nobody guides me on how to use them" was associated with higher odds of medium/high MedDiet adherence (aOR = 1.289; 95% CI: 1.002-1.659). Conclusion: Among adults after bariatric surgery, taste-preference indicators and perceptions regarding FOP warning labels were independently associated with MedDiet adherence. Given the cross-sectional design, these findings should be interpreted as associations rather than causal relationships and highlight the need to strengthen label literacy during postoperative nutrition education.
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spelling oai:cris.upeu.edu.pe:20.500.15037/2262026-10-30T16:14:33ZAssociation of front-of-package warning label perceptions with Mediterranean diet adherence after bariatric surgeryLaboriano Milián, Sila MaribelPalomino Ruiz, Lesly PamelaMorales Garcia, Wilter CharmingCalizaya Milla, Yaquelin EvelingMedicineSurgeryAssociation (psychology)Mediterranean dietPerceptionObesityDiseaseInternal medicineEnvironmental healthMEDLINEEmergency medicineEpidemiologyDiabetes mellitusHealth Sciences Medicine Public Health, Environmental and Occupational Health Consumer Attitudes and Food LabelingHealth Sciences Medicine Surgery Bariatric Surgery and OutcomesHealth Sciences Health Professions Pharmacy Obesity and Health PracticesBackground: Front-of-package (FOP) warning labels are intended to support healthier food choices; however, evidence on how patients perceive these warnings after bariatric surgery and how such perceptions relate to dietary quality is limited. We examined the association between perceptions of FOP warning labels and Mediterranean diet (MedDiet) adherence among adults after bariatric surgery in Lima, Peru. Methods: This was an observational, analytical, cross-sectional study of 200 adults (18-59 years) attending postoperative follow-up at a private clinic in Lima, Peru. MedDiet adherence was assessed using the KIDMED index (originally developed for children/adolescents and used here as a proxy measure of MedDiet-aligned behaviors), and perceptions/understanding of FOP octagonal warnings were measured using a previously validated Peruvian questionnaire. Associations were evaluated using bivariate analyses and multivariable logistic regression, reporting adjusted odds ratios (aOR) and 95% confidence intervals (CI). Results: In adjusted models, higher self-reported preference for salty foods (aOR = 0.261; 95% CI: 0.136-0.501) and sweet foods (aOR = 0.490; 95% CI: 0.263-0.913) were associated with lower odds of medium/high MedDiet adherence. Greater agreement with the statement "I would follow the octagons, but nobody guides me on how to use them" was associated with higher odds of medium/high MedDiet adherence (aOR = 1.289; 95% CI: 1.002-1.659). Conclusion: Among adults after bariatric surgery, taste-preference indicators and perceptions regarding FOP warning labels were independently associated with MedDiet adherence. Given the cross-sectional design, these findings should be interpreted as associations rather than causal relationships and highlight the need to strengthen label literacy during postoperative nutrition education.Articlehttps://pubmed.ncbi.nlm.nih.gov/42027743https://doi.org/10.1016/j.obpill.2026.10026610.1016/j.obpill.2026.100266https://hdl.handle.net/20.500.15037/226W7154337568enObesity Pillars2667-36812026-04-142026-06-13T08:04:04Z2026-06-13T08:04:04Z
spellingShingle Medicine
Surgery
Association (psychology)
Mediterranean diet
Perception
Obesity
Disease
Internal medicine
Environmental health
MEDLINE
Emergency medicine
Epidemiology
Diabetes mellitus
Health Sciences Medicine Public Health, Environmental and Occupational Health Consumer Attitudes and Food Labeling
Health Sciences Medicine Surgery Bariatric Surgery and Outcomes
Health Sciences Health Professions Pharmacy Obesity and Health Practices
Laboriano Milián, Sila Maribel
Palomino Ruiz, Lesly Pamela
Morales Garcia, Wilter Charming
Calizaya Milla, Yaquelin Eveling
Association of front-of-package warning label perceptions with Mediterranean diet adherence after bariatric surgery
title Association of front-of-package warning label perceptions with Mediterranean diet adherence after bariatric surgery
title_full Association of front-of-package warning label perceptions with Mediterranean diet adherence after bariatric surgery
title_fullStr Association of front-of-package warning label perceptions with Mediterranean diet adherence after bariatric surgery
title_full_unstemmed Association of front-of-package warning label perceptions with Mediterranean diet adherence after bariatric surgery
title_short Association of front-of-package warning label perceptions with Mediterranean diet adherence after bariatric surgery
title_sort association of front of package warning label perceptions with mediterranean diet adherence after bariatric surgery
topic Medicine
Surgery
Association (psychology)
Mediterranean diet
Perception
Obesity
Disease
Internal medicine
Environmental health
MEDLINE
Emergency medicine
Epidemiology
Diabetes mellitus
Health Sciences Medicine Public Health, Environmental and Occupational Health Consumer Attitudes and Food Labeling
Health Sciences Medicine Surgery Bariatric Surgery and Outcomes
Health Sciences Health Professions Pharmacy Obesity and Health Practices
topic_facet Medicine
Surgery
Association (psychology)
Mediterranean diet
Perception
Obesity
Disease
Internal medicine
Environmental health
MEDLINE
Emergency medicine
Epidemiology
Diabetes mellitus
Health Sciences Medicine Public Health, Environmental and Occupational Health Consumer Attitudes and Food Labeling
Health Sciences Medicine Surgery Bariatric Surgery and Outcomes
Health Sciences Health Professions Pharmacy Obesity and Health Practices
url https://pubmed.ncbi.nlm.nih.gov/42027743
https://doi.org/10.1016/j.obpill.2026.100266
https://hdl.handle.net/20.500.15037/226
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AT moralesgarciawiltercharming associationoffrontofpackagewarninglabelperceptionswithmediterraneandietadherenceafterbariatricsurgery
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