Impact of different front-of-pack nutrition labels on online food choices

Several studies have identified Front-of-Pack Nutrition Labels (FoPLs) as a promising strategy to improve the nutritional quality of consumers’ food choices and encourage manufacturers to offer healthier products. This study aims to fill the evidence gap regarding the most effective FoPL among the Portuguese population. In total, 1059 Portuguese participants were recruited through a web panel provider and asked to declare their intended food choices and to rank three sets of products (pizza, cakes and breakfast cereals) according to their nutritional quality, first in the absence of any labelling, and then with a FoPL displayed on-pack (five FoPLs tested). Finally, participants were asked to answer nine statements related to perceptions of FoPLs. Results showed that participants improved their food choices, depending on the FoPL and the food category. All FoPLs led to a higher percentage of correct responses on the ranking task compared to the no label condition. The Nutri-Score was among the FoPLs producing the greatest improvement across all food categories compared to the reference intakes (OR = 6.45 [4.43–9.39], p-value < 0.0001) and facilitating the highest percentage to correctly rank products according to nutritional quality. This study suggests that, among the available options, Nutri-Score is the most efficient FoPL to inform Portuguese consumers of the nutritional quality of foods and help them identify healthier options in mock purchasing situations.

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Self-reported use of nutrition labels to make food choices is associated with healthier dietary behaviours in adolescents

Public Health Nutrition ◽

10.1017/s1368980017001252 ◽

2017 ◽

Vol 20 (13) ◽

pp. 2329-2339 ◽

Cited By ~ 7

Author(s):

Amier Haidar ◽

Felicia R Carey ◽

Nalini Ranjit ◽

Natalie Archer ◽

Deanna Hoelscher

Keyword(s):

Physical Activity ◽

High School Students ◽

Parent Education ◽

Food Choices ◽

Nutrition Knowledge ◽

Healthy Weight ◽

Nutrition Label ◽

Nutrition Labels ◽

Dietary Behaviours ◽

Label Use

AbstractObjectiveThe study aimed to examine nutrition label use and dietary behaviours among ethnically diverse middle- and high-school students, in Texas, USA.DesignThe School Physical Activity and Nutrition (SPAN) survey is a cross-sectional statewide study using a self-administered questionnaire to assess nutrition and physical activity behaviours. Height and weight measurements were used to determine BMI. Multivariable logistic regression was used to determine associations between nutrition label use and dietary behaviours, with gender, grade, ethnicity, BMI, parent education, socio-economic status and nutrition knowledge as covariates.SettingParticipants from 283 schools, weighted to represent Texas youth.SubjectsSPAN 2009–2011 included 6716 8th and 11th graders (3465 girls and 3251 boys). The study population consisted of 39·83 % White/Other, 14·61 % African-American and 45·56 % Hispanic adolescents; with a mean age of 14·9 years, and 61·95 % at a healthy weight, 15·71 % having overweight and 22·34 % having obesity.ResultsAdolescents who did not use nutrition labels had 1·69 times greater odds of consuming ≥1 sugary beverages/d (P<0·05). Adolescents who used nutrition labels had 2·13 times greater odds of consuming ≥1 fruits and vegetables/d (P<0·05). Adolescents who used nutrition labels had significantly higher healthy eating scores than those who did not (P<0·001). For every 1-point increase in nutrition knowledge, adolescents had 1·22 greater odds of using nutrition labels.ConclusionsNutrition label use is associated with healthier dietary behaviours in adolescents. Intervention strategies for youth should include efforts to teach adolescents to use labels to make healthy food choices.

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Impact of explained v. unexplained front-of-package nutrition labels on parent and child food choices: a randomized trial

Public Health Nutrition ◽

10.1017/s1368980016002676 ◽

2016 ◽

Vol 20 (5) ◽

pp. 774-785 ◽

Cited By ~ 18

Author(s):

Dan J Graham ◽

Rachel G Lucas-Thompson ◽

Megan P Mueller ◽

Melanie Jaeb ◽

Lisa Harnack

Keyword(s):

Randomized Trial ◽

Saturated Fat ◽

Food Choices ◽

Control Group ◽

Traffic Light ◽

Consumer Awareness ◽

Nutrition Labels ◽

Calorie Content ◽

Parent Child

AbstractObjectiveThe present study investigated whether parent/child pairs would select more healthful foods when: (i) products were labelled with front-of-package (FOP) nutrition labels relative to packages without labels; (ii) products were labelled with colour-coded Multiple Traffic Light (MTL) FOP labels relative to monochromatic Facts up Front (FuF) FOP labels; and (iii) FOP labels were explained via in-aisle signage v. unexplained.DesignParticipants were randomly assigned to one of five conditions: (i) FuF labels with in-aisle signs explaining the labels; (ii) FuF labels, no signage; (iii) MTL labels with in-aisle signage; (iv) MTL labels, no signage; (v) control group, no labels/signage. Saturated fat, sodium, sugar and energy (calorie) content were compared across conditions.SettingThe study took place in a laboratory grocery aisle.SubjectsParent/child pairs (n 153) completed the study.ResultsResults did not support the hypothesis that MTL labels would lead to more healthful choices than FuF labels. The presence of FOP labels did little to improve the healthfulness of selected foods, with few exceptions (participants with v. without access to FOP labels selected lower-calorie cereals, participants with access to both FOP labels and in-aisle explanatory signage selected products with less saturated fat v. participants without explanatory signage).ConclusionsNeither MTL nor FuF FOP labels led to food choices with significantly lower saturated fat, sodium or sugar. In-aisle signs explaining the FOP labels were somewhat helpful to consumers in making more healthful dietary decisions. New FOP labelling programmes could benefit from campaigns to increase consumer awareness and understanding of the labels.

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Front-of-pack nutrition labels: perceptions and preferences of Brazilian adult consumers

British Food Journal ◽

10.1108/bfj-05-2021-0588 ◽

2022 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Ana Claudia Mazzonetto ◽

Ana Carolina Fernandes ◽

Aretusa Dias de Souza ◽

Vanessa Mello Rodrigues ◽

Tailane Scapin ◽

...

Keyword(s):

Regulatory Agency ◽

Food Choices ◽

Purchase Decisions ◽

Warning Labels ◽

Traffic Light ◽

Nutrition Labels ◽

Content Type ◽

Black Triangle ◽

Small Pool ◽

Labeling System

PurposeThis study aimed to examine the perceptions and preferences of Brazilian adult consumers about four different front-of-pack (FOP) food labeling systems proposed by the Brazilian National Health Regulatory Agency.Design/methodology/approachThis is a qualitative study conducted with 33 participants allocated in six focus groups. Four different types of FOP labels were displayed on processed and packaged bread: three interpretive warning labels (black triangle, black octagon and red ellipse) and a hybrid model (nutritional traffic light). Thematic analysis was used to identify the key topics addressed by participants.FindingsThree topics were identified: label design, clarity and precision of information. The results demonstrated an influence of labels on product development and consumers' food choices. Most participants expressed a preference for black warning labels and reported the importance of statements endorsed by the Ministry of Health, which provide credibility and could influence food choices. Furthermore, participants agreed that the traffic light system provides more information but is difficult to interpret when comparing products. Warning labels were reported to have the greatest influence on purchase decisions. However, participants were concerned about how to understand the lack of warning labels on some products.Practical implicationsThe results may help and support the Brazilian Health Regulatory Agency to identify and recommend the most effective FOP labeling system to be adopted in Brazil.Originality/valueFew studies investigating adult consumers' perceptions of different FOP label formats have been conducted in the Brazilian context. Our study contributes to the small pool of evidence on the topic by demonstrating that FOP labels can be helpful for consumers when they are presented in an intuitive, interpretative and trustworthy format.

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Improving the design of nutrition labels to promote healthier food choices and reasonable portion sizes

International Journal of Obesity ◽

10.1038/ijo.2014.86 ◽

2014 ◽

Vol 38 (S1) ◽

pp. S25-S33 ◽

Cited By ~ 60

Author(s):

C A Roberto ◽

N Khandpur

Keyword(s):

Food Choices ◽

Nutrition Labels ◽

Portion Sizes

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Objective understanding of the Nutri-score front-of-pack label by European consumers and its effect on food choices: an online experimental study

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-020-01053-z ◽

2020 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Manon Egnell ◽

Zenobia Talati ◽

Pilar Galan ◽

Valentina A. Andreeva ◽

Stefanie Vandevijvere ◽

...

Keyword(s):

Food Choice ◽

Nutritional Quality ◽

Food Choices ◽

Rating System ◽

Nutrition Labels ◽

Star Rating ◽

Logistic Regression Models ◽

Traffic Lights ◽

Food Packages ◽

Objective Understanding

Abstract Background The effectiveness of Front-of-Pack nutrition Labels (FoPLs) may be influenced by national context. In light of the ongoing efforts to harmonize FoPLs across Europe, this study aimed to compare the effectiveness of five FoPLs (Health Star Rating system, Multiple Traffic Lights, Nutri-Score, Reference Intakes, Warning symbols) on consumer understanding and food choice in 12 European countries. Methods In 2018–2019, for three food categories, approximately 1000 participants per country were asked to select which food they would prefer to purchase between three products with distinct nutritional quality profiles, and then to rank the products by nutritional quality. Participants (N = 12,391 in total) completed these tasks first with no FoPL and then, after randomization to one of the five FoPLs, with a FoPL on the food packages. Associations between FoPLs and change in (i) nutritional quality of food choices and (ii) ability to correctly rank the products by nutritional quality were assessed with logistic regression models adjusted for sociodemographic and lifestyle characteristics of participants, conducted overall and by country. Findings Compared with the Reference Intakes, the Nutri-Score (OR = 3.23[2.75–3.81]; p < 0.0001), followed by the Multiple Traffic Lights (OR = 1.68[1.42–1.98]; p < 0.0001), was the most effective FoPL in helping consumers identify the foods’ nutritional quality, overall and in each of the 12 countries. Differences between FoPLs regarding food choice modifications were smaller, but the effect of the Nutri-Score seemed slightly higher in eliciting healthier food choices overall compared with the Reference Intakes, followed by the Warning symbols, the Multiple Traffic Lights and the Health Star Rating system. Interpretation In the context of FoPL harmonization in Europe, these findings from an online experiment provide insights into the Nutri-Score’s effectiveness on European consumers.

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Online Consumer Survey Comparing Different Front-of-Pack Labels in Greece

Nutrients ◽

10.3390/nu14010046 ◽

2021 ◽

Vol 14 (1) ◽

pp. 46

Author(s):

Lamprini Kontopoulou ◽

George Karpetas ◽

Εvangelos C. Fradelos ◽

Ioanna V. Papathanasiou ◽

Foteini Malli ◽

...

Keyword(s):

Nutritional Quality ◽

Online Survey ◽

Multinomial Logistic Regression ◽

Food Choices ◽

Nutrition Labeling ◽

Nutrition Labels ◽

Logistic Regression Models ◽

Traffic Lights ◽

Quality Of Food

According to the WHO, front-of-pack nutrition labeling provides simplified nutrition information in the form of symbols, colors or words that can help consumers understand the nutritional quality of food, thus leading them to healthier food choices. It is considered of the utmost importance to explore the knowledge and understanding of consumers about this form of nutrition labeling. The aim of this study was to investigate the understanding and perceptions of Greek consumers in response to five different front-of-pack nutrition labels (FoPLs): the Multiple Traffic Lights, Health Star Rating System, Guideline Daily Amounts, Warning Symbols and Nutri-Score. From April 2021 to June 2021, 1278 participants from Greece took part in an online survey where they were asked to rank three products according to their nutritional quality. The classification process was performed first without FoPLs and then with FoPLs. The ability to classify products according to their nutritional quality was evaluated with multinomial logistic regression models, and the Nutri-Score label presented greater improvements when compared to the GDA label for Greek consumers. The Nutri-Score seemed to better help the Greek consumers rank foods according to their nutritional value.

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Effects on Consumers’ Subjective Understanding and Liking of Front-of-Pack Nutrition Labels: A Study on Slovenian and Dutch Consumers

Foods ◽

10.3390/foods10122958 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2958

Author(s):

Angelo Baccelloni ◽

Andrea Giambarresi ◽

Marco Francesco Mazzù

Keyword(s):

The Netherlands ◽

Nutritional Quality ◽

Food Choices ◽

Limited Evidence ◽

Ongoing Debate ◽

Nutrition Labels ◽

Protective Food ◽

Specific Label

In the context of the ongoing debate on front-of-pack labels (FOPL), extant research highlights a lack of clear indications on which label is most effective in increasing consumers’ knowledge of food nutritional quality, and in favoring informed food choices. In this study, we have compared the effects of two different labels, one nutrient-specific label (i.e., NutrInform Battery) and one summary label (i.e., Nutri-Score), in terms of consumers’ “subjective understanding” and “liking”. Our work advances prior research on FOPL performance by focusing on two different countries—which have different socio-political contexts and which, from previous studies, present limited evidence on the topic—Slovenia, currently utilizing the Protective Food logo, and the Netherlands, who has recently adopted the Nutri-Score. The study also confirms, in line with previous research, a higher effectiveness of the nutrient-specific label, NutrInform Battery, on all analyzed dimensions in tested countries, when compared to the summary label, Nutri-Score.

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Objective understanding of the front-of-pack nutrition label Nutri-Score by European consumers

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.902 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Egnell ◽

Z Talati ◽

P Galan ◽

V Andreeva ◽

S Vandevijvere ◽

...

Keyword(s):

Nutritional Quality ◽

Food Choices ◽

Nutrition Labels ◽

Logistic Regression Models ◽

Traffic Lights ◽

Nutrition Labelling ◽

Food Packages ◽

Objective Understanding ◽

Quality Of Food

Abstract Background The effectiveness of Front-of-Pack nutrition Labels (FoPL) may be influenced by national context. In light of the ongoing efforts to harmonize nutrition labelling across Europe, the study aimed to compare the effectiveness of five FoPLs (Health Star Rating system [HSR], Multiple Traffic Lights [MTL], Nutri-Score, Reference Intakes [RIs], Warning symbol) in 12 European consumers. Methods In 2018-2019, for three food categories, approximately 1,000 participants per country were asked to select which food they would prefer to purchase between three products with distinct nutritional quality, and then to rank the products nutritional quality. Participants completed these tasks first with no FoPL and then, after randomization to one of the five FoPLs, with a FoPL on food packages. Associations between FoPLs and change in (i) nutritional quality of food choices, and (ii) ability to correctly rank the products nutritional quality were assessed with multivariable logistic regression models. Results Compared with the RIs, the Nutri-Score (OR = 3·23[2·75-3·81]; p < 0.0001), followed by the MTL (OR = 1·68[1·42-1·98]; p < 0.0001), was the most effective FoPL in helping participants identify the foods nutritional quality, overall and in each of the 12 countries. Differences between FoPLs regarding food choice modifications were smaller, but the effect of the Nutri-Score was slightly higher in eliciting healthier food choices overall compared with the RIs, followed by the Warning symbol, MTL and HSR. Conclusions These findings from an online experiment provide insights on the Nutri-Score's effectiveness in multiple European countries in the context of FoPL harmonization in Europe. Key messages The comparison of the effectiveness of front-of-pack labels highlighted the relative performance of various types of labels, the Nutri-Score showing a higher performance than other schemes. The higher performance of the Nutri-Score was identified for objective understanding and to a lesser extent food choices.

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