Effectiveness of Different Front-of-Pack Nutrition Labels among Italian Consumers: Results from an Online Randomized Controlled Trial

In Italy, discussions are currently ongoing to implement a front-of-pack nutrition label (FoPL) while a growing number of European countries are adopting the Nutri-Score. The effectiveness of the Nutri-Score among Italian consumers requires further investigation. This study compared five FoPLs among Italian participants (Health Star Rating system, multiple traffic lights, Nutri-Score, reference intakes, warning symbol) in terms of food choices and understanding of the labels by consumers. In 2019, 1032 Italian consumers completed an online survey in which they were asked to select one product they would likely purchase from a set of three foods with different nutrient profiles and then classify the products within the set according to their nutritional quality, first with no label and then with one of the five FoPLs on the pack. While no significant difference across labels was observed for food choices, the Nutri-Score demonstrated the highest overall performance in helping consumers to correctly rank the products according to their nutritional quality compared to the reference intakes (OR = 2.18 (1.50–3.17), p-value < 0.0001). Our results provide new insights on the effectiveness of the Nutri-Score, which would be a relevant tool to inform Italian consumers on the nutritional quality of food products.

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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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Nutri-Score: The Most Efficient Front-of-Pack Nutrition Label to Inform Portuguese Consumers on the Nutritional Quality of Foods and Help Them Identify Healthier Options in Purchasing Situations

Nutrients ◽

10.3390/nu13124335 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4335

Author(s):

Francisco Goiana-da-Silva ◽

David Cruz-e-Silva ◽

Catarina Nobre-da-Costa ◽

Alexandre Morais Nunes ◽

Morgane Fialon ◽

...

Keyword(s):

Nutritional Quality ◽

Food Choices ◽

P Value ◽

Portuguese Population ◽

Food Category ◽

Nutrition Labels ◽

Label Condition ◽

Promising Strategy ◽

Ranking Task

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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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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Consumers’ Responses to Front-of-Pack Nutrition Labelling: Results from a Sample from The Netherlands

Nutrients ◽

10.3390/nu11081817 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1817 ◽

Cited By ~ 13

Author(s):

Egnell ◽

Talati ◽

Gombaud ◽

Galan ◽

Hercberg ◽

...

Keyword(s):

The Netherlands ◽

Nutritional Quality ◽

Food Choices ◽

European Countries ◽

Star Rating ◽

Traffic Lights ◽

Nutrition Labelling ◽

Significant Difference ◽

Overall Performance ◽

Nutritional Profiles

Front-of-pack labels (FoPLs) are efficient tools for helping consumers identify healthier food products. Although discussions on nutritional labelling are currently ongoing in Europe, few studies have compared the effectiveness of FoPLs in European countries, including the Netherlands. This study aimed to compare five FoPLs among Dutch participants (the Health Star Rating (HSR) system, Multiple Traffic Lights (MTL), Nutri-Score, Reference Intakes (RIs), and Warning symbols) in terms of perception and understanding of the labels and food choices. In 2019, 1032 Dutch consumers were recruited and asked to select one product from among a set of three foods with different nutritional profiles, and then rank the products within the sets according to their nutritional quality. These tasks were performed with no label and then with one of the five FoPLs on the package, depending on the randomization arm. Finally, participants were questioned on their perceptions regarding the label to which they were exposed. Regarding perceptions, all FoPLs were favorably perceived but with only marginal differences between FoPLs. While no significant difference across labels was observed for food choices, the Nutri-Score demonstrated the highest overall performance in helping consumers rank the products according to their nutritional quality.

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Effects of front-of-pack labels on the nutritional quality of supermarket food purchases: evidence from a large-scale randomized controlled trial

Journal of the Academy of Marketing Science ◽

10.1007/s11747-020-00723-5 ◽

2020 ◽

Vol 49 (1) ◽

pp. 119-138 ◽

Cited By ~ 10

Author(s):

Pierre Dubois ◽

Paulo Albuquerque ◽

Olivier Allais ◽

Céline Bonnet ◽

Patrice Bertail ◽

...

Keyword(s):

Nutritional Quality ◽

Large Scale ◽

Controlled Trial ◽

Real Life ◽

Grocery Shopping ◽

Nutrition Labels ◽

Nutrition Quality ◽

Food Purchases ◽

The Mean

AbstractTo examine whether four pre-selected front-of-pack nutrition labels improve food purchases in real-life grocery shopping settings, we put 1.9 million labels on 1266 food products in four categories in 60 supermarkets and analyzed the nutritional quality of 1,668,301 purchases using the FSA nutrient profiling score. Effect sizes were 17 times smaller on average than those found in comparable laboratory studies. The most effective nutrition label, Nutri-Score, increased the purchases of foods in the top third of their category nutrition-wise by 14%, but had no impact on the purchases of foods with medium, low, or unlabeled nutrition quality. Therefore, Nutri-Score only improved the nutritional quality of the basket of labeled foods purchased by 2.5% (−0.142 FSA points). Nutri-Score’s performance improved with the variance (but not the mean) of the nutritional quality of the category. In-store surveys suggest that Nutri-Score’s ability to attract attention and help shoppers rank products by nutritional quality may explain its performance.

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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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Objective Understanding of Front-of-Package Nutrition Labels: An International Comparative Experimental Study across 12 Countries

Nutrients ◽

10.3390/nu10101542 ◽

2018 ◽

Vol 10 (10) ◽

pp. 1542 ◽

Cited By ~ 58

Author(s):

Manon Egnell ◽

Zenobia Talati ◽

Serge Hercberg ◽

Simone Pettigrew ◽

Chantal Julia

Keyword(s):

Experimental Study ◽

Nutritional Quality ◽

Online Survey ◽

Rating System ◽

Label Free ◽

Free Products ◽

Nutrition Labels ◽

Traffic Lights ◽

Objective Understanding ◽

International Comparative

Front-of-Package labels (FoPLs) are efficient tools for increasing consumers’ awareness of foods’ nutritional quality and encouraging healthier choices. A label’s design is likely to influence its effectiveness; however, few studies have compared the ability of different FoPLs to facilitate a consumer understanding of foods’ nutritional quality, especially across sociocultural contexts. This study aimed to assess consumers’ ability to understand five FoPLs [Health Star Rating system (HSR), Multiple Traffic Lights (MTL), Nutri-Score, Reference Intakes (RIs), and Warning symbol] in 12 different countries. In 2018, approximately 1000 participants per country were recruited and asked to rank three sets of label-free products (one set of three pizzas, one set of three cakes, and one set of three breakfast cereals) according to their nutritional quality, via an online survey. Participants were subsequently randomised to one of five FoPL conditions and were again asked to rank the same sets of products, this time with a FoPL displayed on pack. Changes in a participants’ ability to correctly rank products across the two tasks were assessed by FoPL using ordinal logistic regression. In all 12 countries and for all three food categories, the Nutri-Score performed best, followed by the MTL, HSR, Warning symbol, and RIs.

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PERAN WARGA PEDULI AIDS CAHAYA CARE TUREN DALAM MENINGKATKAN KUALITAS HIDUP ODHA

Jurnal Kesehatan Mesencephalon ◽

10.36053/mesencephalon.v3i1.37 ◽

2017 ◽

Vol 3 (1) ◽

Author(s):

Tri Nurhudi Sasono

Keyword(s):

Quality Of Life ◽

Antiretroviral Drugs ◽

P Value ◽

People Living With Hiv ◽

Purposive Sampling ◽

Significant Difference ◽

Development Goals ◽

Living With Hiv ◽

Hiv Aids

Abstract : Indicator of the health welfare through Sustanable Development Goals (SDGs) is to reduce the incidence of HIV-AIDS, decrease the rate of the epidemic and maintain the quality of life of people living with HIV-AIDS (PLWHA). Trend cases of HIV-AIDS is the most recent spread among people, especially housewives. In Malang until 2015 found 278 Housewife of 409 cases of AIDS. The prevalence of HIV-AIDS in Malang Regency is ranked second after Surabaya city in East Java. For the importance of public participation and citizen care AIDS Cahaya Care Turen take responsibility for the condition. Determination Rule Goverment number 2 2015 year on the Participation of the community response to HIV-AIDS in Malang as a legal rule. Concerned Citizens activities AIDS (WPA). WPA Cahaya Care Turen is increases HIV risk and quality of life PLWHA. The purpose of this study was to determine the role of Citizens AIDS Cahaya Care Quality of Care Turen against people living with HIV in Puskesmas Turen Malang. The study design using a quasi-experimental, with purposive sampling using a sampling technique. Total number of research subjects 23. Based on test results obtained with the Wilcoxon p value <0.005, which means that there is a significant difference before and after PLWHA joining participated in the WPA Cahaya Care Turen. The conclusion of this study is WPA activities involving people living with HIV and at risk groups can optimize compliance with antiretroviral drugs that have an impact on improving the quality of life of PLHIV. Suggestions in this research is done WPA Program activities are structured and ongoing cross-sector in order to improve the quality of life and empower PLWHA.Keywords : WPA Cahaya Care Turen, Quality of life, PLWHA Abstrak : Salah satu indikator kesejahteraan kesehatan melalui Sustanable Development Goals (SDGs) adalah menekan angka kejadian HIV-AIDS, menurunkan laju epidemik dan mempertahankan kualitas hidup Orang dengan HIV-AIDS (ODHA). Trend kasus HIV-AIDS terkini terbanyak adalah menjangkit dikalangan masyarakat khususnya pada ibu rumah tangga. Kabupaten Malang sampai dengan tahun 2015 ditemukan 278 Ibu Rumah Tangga dari 409 kasus AIDS. Prevalensi HIV-AIDS di Kabupaten Malang ini merupakan peringkat kedua di Jawa Timur setelah Kota Surabaya. Untuk itu pentingnya peran serta masyarakat dan warga peduli AIDS Cahaya Care Turen ikut bertanggung jawab terhadap kondisi tersebut. Penetapan Peraturan Bupati Malang no.2 th.2015 tentang Peran serta masyarakat penanggulangan HIV-AIDS di Kabupaten Malang diharapkan dapat mengurangi risiko penularan HIV dan meningkatkan kualitas hidup ODHA. Tujuan dari penelitian ini adalah untuk mengetahui Peran Warga Peduli AIDS Cahaya Care Turen terhadap Kualitas ODHA Di Wilayah Kerja Puskesmas Turen Kabupaten Malang. Desain penelitian menggunakan quasi eksperimen, dengan teknik sampling menggunakan purposive sampling. Jumlah subyek penelitian sejumlah 23. Berdasarkan hasil uji dengan Wilcoxon didapatkan nilai p value < 0.005 yang berarti bahwa terdapat perbedaan bermakna sebelum dan sesudah ODHA bergabung mengikuti kegiatan WPA Cahaya Care Turen. Kesimpulan dalam penelitian ini adalah kegiatan WPA dengan melibatkan ODHA dan kelompok beresiko dapat mengoptimalkan kepatuhan obat ART sehingga berdampak terhadap peningkatan kualitas hidup ODHA. Saran dalam penelitian ini adalah dilakukannya Program kegiatan WPA yang terstruktur dan berkesinambungan lintas sektor guna meningkatkan kualitas hidup dan memberdayakan ODHA. Kata kunci : WPA Cahaya Care Turen, kualitas hidup, ODHA

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Diabetes knowledge, risk perception, and quality of life among South Asian caregivers in young adulthood

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001268 ◽

2020 ◽

Vol 8 (2) ◽

pp. e001268

Author(s):

Angela Koipuram ◽

Sandra Carroll ◽

Zubin Punthakee ◽

Diana Sherifali

Keyword(s):

Quality Of Life ◽

Risk Perception ◽

South Asian ◽

Online Survey ◽

Educational Interventions ◽

Cross Sectional Study ◽

Cross Sectional ◽

Significant Difference ◽

Design And Methods

IntroductionPersons of South Asian descent have a higher prevalence of type 2 diabetes mellitus (T2DM). The management of T2DM in the South Asian community has required the support of adult children, potentially impacting the quality of life, diabetes-related knowledge, and risk perception among these caregivers.Research design and methodsTo investigate diabetes-related knowledge, quality of life, risk perception, and actual risk of developing diabetes among South Asian young adults whose parents are living with T2DM. A cross-sectional study was conducted (n=150). An online survey was administered. Data were analyzed with descriptive and inferential statistics.ResultsThere was a statistically significant difference in diabetes-related knowledge between males and females (p<0.001). Males (in comparison to females) had a lower risk perception of developing diabetes (p=0.06). Further, risk perception and diabetes-related knowledge were positively associated with caregiver’s physical health (p=0.002).ConclusionFindings highlight the importance of providing gender-specific and culturally tailored diabetes educational interventions.

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Sleeve gastrectomy is the most common cause of Gastro-esophageal Reflux Disease in comparison with other bariatric operations

Digestive Diseases ◽

10.1159/000514377 ◽

2021 ◽

Author(s):

majdi abu sneineh ◽

malek abu sneineh ◽

Monther Abu Sneineh ◽

mustafa abu sneineh ◽

muneer abu snineh ◽

...

Keyword(s):

Bariatric Surgery ◽

Medical Center ◽

Bariatric Procedure ◽

P Value ◽

Significant Difference ◽

Symptomatic Gerd ◽

Swallow Study ◽

Contrast Swallow ◽

Gerd Symptoms

Abstract Introduction GERD is one of the complications of bariatric operations that might affect the quality of life. We aim to perform a retrospective cohort study to determine the incidence of symptomatic GERD following different types of bariatric surgery and which operations are considered a contraindication of GERD. Besides, we are attempting to identify the risk factors of GERD after bariatric surgery. Methods Medical records of 729 patients undergone bariatric operations between January 2010 and June 2019 at Shamir (Assaf Harofeh) Medical Center were reviewed. Results There was a significant difference between the type of bariatric procedure and the incidence of GERD symptoms after the operation. The incidence of symptomatic GERD in patients who underwent SG was 39.9% (p =0.0131). This was significantly higher compared to 16.4% following roux en y gastric bypass, 23.4% following LAGB, and 11% following OAGB. 113 patients out of 718 had a positive swallow test and of these patient 71 developed GERD symptoms post-operatively without correlation to the degree of reflux at the swallow test but with statistically significant correlation to the type of operation especially for SG (P-value <0.001) and to our knowledge this was never reported in the literature. Conclusion SG is a good bariatric procedure option but should be contraindicated in asymptomatic reflux contrast swallow study and symptomatic GERD patients preoperatively because of high levels of symptomatic GERD post-operatively. Asymptomatic reflux at contrast swallow study pre-operatively should be considered a risk factor for GERD after the operation.

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