Country context, personal values and nutrition trust: Associations with perceptions of beverage healthiness in five countries in the Asia Pacific region

The increasing consumption of sugar-sweetened beverages in middle-income countries is having significant detrimental health effects. Beverage choices are influenced by consumers’ perceptions of products. Understanding the factors influencing perceptions is essential to reducing consumption of unhealthy beverages. To date little research has been conducted in this area, particularly outside of Western contexts. This study aimed to examine the health-related perceptions of non-alcoholic beverages and associated factors in five countries in the Asia Pacific region. A cross-sectional online survey was administered to middle-class household food providers in Melbourne, Shanghai, Vietnam, Indonesia and Singapore (n = 3951, 57% female). Participants rated the healthiness of common beverages and information on demographics, trust in sources of nutrition information and personal values was obtained. Data was analysed via principal components analysis and multiple linear regressions. Results demonstrated that both demographic and psychographic factors were associated with the perceived healthiness of beverages. Respondents perceived beverage healthiness in four types: sweetened, heavily marketed beverages, milk-based and children's products, unsweetened, minimally processed beverages and waters. The perceived healthiness of sweetened, heavily marketed beverages and milk-based and children's products was higher in Vietnam, Shanghai and Indonesia than in Singapore and Melbourne and positively associated with trust in industry sources of nutrition information and hedonist values. Perceiving unsweetened, minimally processed beverages as healthy was associated with trust in health authorities and equality-nature values. Reducing the perceived healthiness and consumption of unhealthy drinks requires nutrition education that responds to economic and cultural contexts and frames messages to appeal to prevailing personal values.