Consumers’ Level of Awareness and Safety Perceptions of Food Additives

Aims: We aimed to measure the prevalence of Jeddah residents’ knowledge and their awareness of these ingredients. Study Design: A cross-sectional study. Place and Duration of Study: The study conducted in Jeddah, Saudi Arabia, during 2019. Methodology: This study was cross-sectional via an electronic survey that was handed out, and 676 of 868 respondents fit the inclusion criteria: all individuals were eighteen and above in addition to residing in Jeddah in 2019. Statistical analysis was performed using SPSS version 21. Pearson's chi-square was used to test association. Results: The results showed that 63.5% of consumers needed more information about food additives. About 80.5% were familiar with preservatives which, in their opinion, were the most disconcerting food additives. Moreover, 37.2% desired easier and accurate labels to gain a better understanding of this topic, while 43.6% said that the most acceptable idea for disseminating information about food additives to the public was by animation in independent display areas. Conclusion: The study’s findings are examined in terms of the implications for future research and for the development of concrete communication materials to improve food additive awareness in Jeddah, Saudi Arabia. The level of knowledge was low. Further studies are needed to be done in Saudi Arabia about this topic. Original Research Article Al-Ghamdi et al.; JPRI, 33(60B): 1665-1674, 2021; Article no.JPRI.80486 1666


INTRODUCTION
Food additives are chemical ingredients that can occur naturally or can be synthetised. They are added to food as a way of enhancing the flavor or appearance or are used as protection to extend the shelflife and expiration, where several additives are important to avoid the multiplication/survival of pathogens of serious concern in foods [1].
These additives are convenient and easily accessible but may cause side effects, food allergies, increased waistlines, decreased absorption of minerals and vitamins, and more health issues. Young people suffer the most because they are exposed to these chemicals from infancy [2].
The consumption rate of processed food has increased rate over the years. Where, the cahrechterestics of consumers (gender, income rate, education, and age) influenc the consumption and many factors can affect foodrelated problems, such as gender, income rate, education, and age [3]. Usually, ordinary consumers do not pay attention to the food additives information and warnings on packages. An essential factor of this phenomena is the lack of knowledge about preservatives' importance and effects, although some researchers have shown that consumers want to be better informed about the effects of additives [4].
The use of food additives to hide food deterioration or spoilage or to cheat consumers is expressly forbidden by regulations governing the use of these items in foods. Moreover, food additives usage is stifled where comparable influences can be obtained by economic, good industry practices [5].
The most important element in processed foods production is the consumer, including which products and services are produced to satisfy the consumer's needs. Thus, consumers' decisions to purchase or reject a product is an essential factor [6].
Food additives health-related should be minimized. Also, food manufacturers must pay attention by checking food quality before offering it for sale, and consumers should be educated about food additives [7].
A previous study in South Korea in 2011 measured the public awareness of food additives with a participation rate of 94%, as 430 of 470 consumers responded. According to their answers, one of the main reasons for consuming processed food was its flavor [1]. In a study that took place at the University of Mauritius campus in 2014, 180 participants were interviewed, and it was found that 65% never checked food additives labels [3].
A point worth mentioning is that, when customers become more aware of the impact of certain items on health issues, they will want to make intellectual food choices.
There are no studies on this topic in our local Middle East area, especially in Saudi Arabia, but it is necessary for each country to pay attention because of the magnitude of health impacts caused by food additives. We aim to investigate the prevalence of consumers' awareness and their knowledge about food additives in Jeddah, Saudi Arabia, in 2019.

MATERIALS AND METHODS
A cross-sectional study was conducted in Jeddah, Saudi Arabia, during June 2019. The study was under the supervision of the Physiology Department and was approved by the Institutional Review Board (IRB) of King Abdul-Aziz University Hospital (KAUH). A sample size of 385 study subjects was calculated using a confidence level of 95% and a margin error of 5% and was conducted by an online questionnaire [1].
We calculated 676 out of 868 participants to decrease the margin of error. The participants included Jeddah residents and excluded individuals under 18 years and who were visitors not permanently living in Jeddah. The following data were extracted from the survey: demographic data (age, education status, sectoral distribution, gender), whether participants had a habit of reading food labels, and whether they could understand the food additives information on the labels. Questions regarding the awareness of food additives included the following: Whether it is safe to buy processed foods containing food additives, the reason behind using food additives, the most known food additives, the participant's opinion on why the food additives information is inadequate, and what essential information about food additives should be given to the public.
The answers were in the form of options (usage purpose, contents of food additives, or information of harmless ratio), including from which source they get food additives information.
To find consumers' awareness and safety perceptions of food additives and processed food, the following questions about safety perceptions were included: whether participants suspect that legally permitted food additives are not safe and why, and their expectations of the government regarding food additives (controlling the ratio of additives in food, reducing the ratio of understandable labels, or including the most important information about food additives on the label). Data entry was done using Microsoft Excel 2016, and a statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 21.

RESULTS AND DISCUSSION
A statistical description of the respondents' demographic data is as follows. For gender, approximately 78.8% were female, and 21.2% were male. For age, 73.5% were younger than 30, 10.5% were in their 30s, 9.5% were in their 40s, 5.8% were in their 50s, and 0.7% were older than 60. For social status, 69.5% were single, 27.4% were married, 1.9% were divorced, and 1.2% responded as other. In terms of household income, 20.3% earned less than 5,000 SAR, 10.7% earned between 5,001 and 7,000 SAR, 13.2% earned between 7,001 and 10,000 SAR, 16.7% earned between 10,001 and 15,0000 SAR, and 39.3% earned over 15,000 SAR. Slightly more than half of the respondents (54.4%) had a bachelor's degree, followed by secondary school (32.1%). About 85.2% were Saudi, and 14.8% were non-Saudi.
In terms of frequently purchased food, dairy products ranked the highest at 76.5%, followed by snacks such as chips at 70.9%, and the lowest was flavoring agents at 25.3%.
About 45.1% of the participants believed that the reason behind using food additives was to extend the shelf life of processed foods. Even though 62.7% of the participants answered "Maybe," 24.4% thought food additives were not safe. More than half thought they lacked sufficient knowledge of food additives. Most respondents (42.2%) selected the Internet as the most effective medium for transmitting information on food additives, whereas 22.6% chose product packages.
We asked the population about important food additives information. The highest results were 28.4% for the types of foods containing food additives and 21.7% for intake guides, while the lowest result of 13.8% was for labeling standards. Of the participants, 28.7% purchased processed food two to three times a week. The majority (76%) responded that they preferred buying their food from supermarkets.
Food preservatives (80.5%) were the most common food additives the participants were aware of, as they were found to be the most worrisome in processed food (37.4%), while 24.9% reported that colorants were more concerning, When asked about participants' behavior toward food preservatives and whether they would still use preservatives in the future, 60.7% answered "Sometimes" while only 26.8% responded with "No." Further, 66.4% reported that they would consider purchasing an acceptable daily intake of preservatives. The highest vital facets when purchasing processed foods were taste (94.7%), price (74.7%), nutritional value (57%), and "others" (24.1%).
Moreover, 37.9% of consumers stated that their primary need from the government was easy and accurate labels, and 73.2% will use information if it is provided in the store.
Thirds of the consumers 34.6% chose independent display areas as the best places to present the information, with 10.8% preferring the events section, and 34.6% choosing posters as the desired method. Of all participants, 62.0% admit that they will check the information labels.
In this study, we aimed to measure the prevalence of consumers' knowledge and their awareness about food additives. Of the participants, 78.8% were female because the data collection area included many more females than males, in addition to females being more cooperative in filling out the surveys and their interest in the food additives subject. This is a similar result to Dr. Serap Kayışoğlu's study [8].
We found a significant relationship between "Marital status and frequency of purchasing processed food," whereby single people (22.6%) usually purchase small amounts of processed food (2-3 days' worth) rather than a larger amount that can be consumed over a longer period, for example, a month (p = 0.001).
We found an association between family income and the frequency of purchasing processed food, with 10.5% of high-income participants that make over 15,000 SAR per month buying food additives twice or thrice per week. Their financial stability leads to the overconsumption of processed food, whether it was used for essential nourishment or self-indulgence (p = 0.470). Participants who mainly had a highincome rate (39.2%) stated that their family income was over 15,000 SAR per month. Further, 76% of participants with different family income rates chose supermarkets, which can be a little costlier, as their preferred processed food shopping site but trade in trustworthy products more than grocery and convenience stores (p = 0.331). These results are similar to a study in Western Europe that stated a higher future income would reduce consumer price sensitivity [9].
Most of our respondents were Saudi (85.2%), and their most frequently purchased food was dairy products (64.2%). Since dairy products have a short expiration date, they must be bought frequently. Also, in the Arabian culture, dairy products are everyday essentials for making different types of food (p = 0.079).
According to the survey's results about participants' knowledge of food additives, 80.5% responded with "Yes" they were familiar with food preservatives, 78.7% with flavoring agents, 75.1% with colorants, 72% with bleaching agents, and 70.7% with artificial sweeteners. Food preservatives ranked as the most known and worrisome food additive subtype (31.1%, p = 0.264), and 93.3% of participants chose to justify their lack of knowledge of other food additives because they found them unnecessary. Further, 60.7% of respondents said they will sometimes purchase preservatives in the future (p = 0.039), while 66.4% want to keep their intake level of food additives within an acceptable daily range.
Of the participants, 12.4% who knew about artificial sweeteners were concerned about the possibility of their children getting certain diseases, such as obesity, diabetes, and dental caries (p = 0.009). C Brockman's study showed consumer requirements for reducing the additives in food products by removing artificial colors, flavors, and preservatives in many meals to obtain clean-label products [10,11].
The most preferred method of receiving food additives information for bachelor's degree holders were posters (19.5%). Academically advanced individuals have most likely acquired the habit of reading information and possibly even made posters during their academic years, so they are more familiar with them, while people with lower educational levels may not be as interested in posters and might prefer animation or other visually clear and more uncomplicated methods (p = .000), Almost all generations agreed that the most effective way to transmit information was via the Internet (42.2%), and they selected it over mass media, social relations, poster advertisement, packages, and books or booklets. Up to 70% of the participants were from age group 1 (29 years and less), and 34.6% preferred the Internet (p = 0.00). Although individuals with higher educational attainments (12.9%) had a different opinion of using packages of processed food as an alternate method, due to such qualities as easy accessibility and packages being an ultimate source of information (p = 0.015), the most accepted idea of presenting food additives information was an animation used in independent display areas (10.8%) due to its visual clarity and understandability, which facilitate the information reaching various age groups (p = 0.00).
Of the respondents, 94.7% picked "taste or flavor" as their first vital facet, while nutritional value (57%) was their last choice. This explains the fact that they will purchase more food preservatives (p = 0.009). The spread of processed food and its easy accessibility over that of a healthy nutritious meal was a high factor occupying consumer attention, as 54% of participants think of food additives as convenience products they will purchase in the future (p = 0.014).
We found that 62.7% of participants are not entirely sure that food additives-which are approved by the Saudi Food and Drug Authority-are safe. A similar percentage said they would continue to purchase additives. Therefore, there should be an increase in the government's care toward educating the public on such substances (p = 0.009). More than half the participants (63.8%) wanted simpler, accurate labels that can be easily understood. It showed that the public wants to increase their knowledge about additives and the food components they eat (p = 0.003). "Types of food items that contain food additives" was the highest choice for consumers needing information, while labeling standards was the lowest, which indicates a difficulty in understanding them. Therefore, consumers tend to choose types of food that contain these substances instead of recognizing them on hard-to-understand labels. Only 11.8% realize that the most important demand of the government is to provide smooth and accurate labels, as mentioned before (p = 0.108).
A total of 62% of participants plan to read food labels. While 63.5% of the sample thought they did not have enough information about food additives, only 36.8% are willing to check and read nutritional labels in the future (p = 0.016).
A limitation of this study is that it is a crosssectional design that utilized a self-administered survey questionnaire, so we recommend using interview methods instead.

CONCLUSION
This study aims to measure the prevalence of consumers' awareness, purchasing methods, information needs, and behavior toward processed food among Jeddah residents over eighteen years old. We found that participants will check labels in the future and keep their additives in check, as most were aware and concerned about preservatives. The consumers' behavior will not change if they are not more aware of food additives, so we must establish companies to disseminate information to the general public and to raise awareness using independent display areas to present more information. This study opens doors for further similar Saudi studies.