EXPRESS: When Detailed Information Works Better: Comparison of Three and Five Color/Letter Front-of-Package Nutrition Labels

The adoption of front-of-package (FoP) nutrition labels to promote healthier food choices is increasing worldwide, yet it remains unclear which types of nutrition labels are superior from a public policy perspective. This research compares two common forms of evaluative FoP nutrition labels that vary in the number of colors and corresponding letters they display (three colors, A—C [3C] vs. five colors, A—E [5C]). Four studies, including a field study with vending machines and a study in an experimental supermarket using eye-tracking, show that compared with the 3C label and no label (control) conditions, the 5C label enhances purchase intentions and choices of healthy alternatives. In particular, the 5C nutrition label is superior because it provides more information that helps consumers discriminate the products’ healthiness. This ability to discriminate healthiness modifies consumers’ perceived healthiness of products and influences both their purchase intentions and choice of healthy food options.

Health communication to reduce sugar consumption in Thailand

Excessive sugar consumption is one of the critical health behaviors contributing to Non-Communicable Diseases or NCDs, which are the leading causes of mortality among the Thai population. It is reported that Thai people have a continuous increase in sugar consumption every year associated with higher incidences of NCDs in the country. Therefore, health communication to raise awareness and modify the sugar consumption behavior in Thailand focuses on integrative communication in terms of public policies in accordance with the National NCDs Strategic Plan, guidelines and knowledge in sugar consumption including healthy and unhealthy sugar sources, sugar substitutes and their use in functional foods, health problems related to sugar consumption, the use of GDA Nutrition label, and the application of Healthier Choices standards with appropriate sugar content. With changing lifestyles, social media and technologies play a higher role in health communication regarding sugar consumption, resulting in the development of health applications in conjunction with IoT technology that can be used via smartphones. All these communications aim to promote the reduction of sugar consumption in the prevention of NCDs, thus reducing the premature death rate of the Thai population accordingly.Keywords: health communication, sugar consumption, sugar, sweetener, sugar tax, social media, non-communicable diseases, NCDs, nutrition label, GDA label, IoT

The Nutri-Score nutrition label

Nutri-Score is a front-of-pack nutrition label with summary graded colour-coding, which aims to inform consumers, in a simple and understandable way, of the overall nutritional value of foods, in order to help them to make healthier choices at the point of purchase and to encourage manufacturers to improve the nutritional quality of their products. It is based on a five-colour scale (from dark green to dark orange) associated with letters, from A to E, to optimize logo accessibility and understanding by the consumer. Nutri-Score does not merely characterize foods as “healthy” or “unhealthy”. Rather, the graded logo provides semi-quantitative information, depending on the colour/ letter, of the relative overall nutritional composition of a food product compared to other similar products as to whether it is more or less favourable to health. Nutri-Score is the only proposed labelling scheme that adheres entirely to the concepts and processes that were published by the World Health Organisation (WHO) Europe concerning the validation studies that are required to select and evaluate a front-of-pack nutrition label. The aim of the present paper is to present the scientific basis for the design of the Nutri-Score and to summarize the various studies to validate its calculation method and its graphic format. We explore its effectiveness and superiority compared to other labelling schemes that have been implemented in other countries or supported by pressure groups. The necessity for objective, impartial consideration of how best to use Nutri-Score and avoid misunderstandings is highlighted.

The Relationship between Nutrition Knowledge and Nutrition Facts Table Use in China: A Structural Equation Model

Since 2013, China has implemented a nutrition label regulation that aims to provide essential nutrition information through nutrition facts tables labeled on the back of food packages. Yet, the relationship between people’s nutrition knowledge and their nutrition label use remains less clear. This study adopted the structural equation modeling approach to analyze a nationally representative survey of 1500 Chinese individuals through the cognitive processing model, interrelated nutrition knowledge, attention to nutrition information on the nutrition facts table, comprehension of nutrition information, food choice and dietary intake. It was found that nutrition knowledge positively influenced attention to nutrition information; a better comprehension of nutrition information, which could benefit healthier food choices, did not relate to a higher level of attention to that information; dietary intake was affected significantly by nutrition knowledge, but it had little impact on food choice. The results signify that nutrition knowledge hardly supports nutrition facts table use among the Chinese people, mainly due to incomprehensible labeled information. Therefore, it emphasizes the need to enhance people’s comprehension through front-of-package labels and corresponding smartphone applications.

Nutrition Label Knowledge and Attitude to Affect Healthy Food Choice among Young Consumers in Malaysia

This research attempts to investigate the direct effect of nutrition label knowledge on attitude, and, nutrition label knowledge and attitude in choosing healthy food among Malaysian consumers as well as the role of nutrition label attitude as a mediator. This research applied the quantitative approach. A sample comprised 381 Malaysian consumers with minimum age of 18 years old. Data from a sample were obtained using a structured questionnaire and analysed using structural equation modelling (SEM). The findings reveal that nutrition label knowledge as a significant predictor of nutrition label attitude and, nutrition label knowledge and attitude as significant predictors of healthy food choice. In addition, the findings reveal the nutrition label attitude as a partial mediator in the relationship between nutrition label knowledge and healthy food choice. Although the findings provide fresh insights on the role of nutrition label knowledge and attitude in affecting healthy food choice, this research requires a replication in future research as to improve the explanatory power of the framework.

The impact of the Nutri-Score front-of-pack nutrition label on purchasing intentions of unprocessed and processed foods: post-hoc analyses from three randomized controlled trials

Background The Nutri-Score summary graded front-of-pack nutrition label has been identified as an efficient tool to increase the nutritional quality of pre-packed food purchases. However, no study has been conducted to investigate the effect of the Nutri-Score on the shopping cart composition, considering the type of foods. The present paper aims to investigate the effect of the Nutri-Score on the type of food purchases, in terms of the relative contribution of unpacked and pre-packed foods, or the processing degree of foods. Methods Between September 2016 and April 2017, three consecutive randomized controlled trials were conducted in three specific populations – students (N = 1866), low-income individuals (N = 336) and subjects suffering from cardiometabolic diseases (N = 1180) – to investigate the effect of the Nutri-Score on purchasing intentions compared to the Reference Intakes and no label. Using these combined data, the proportion of unpacked products in the shopping carts, as well as the distribution of products across food categories taking into account the degree of processing (NOVA classification) were assessed by trials arm. Results The shopping carts of participants simulating purchases with the Nutri-Score affixed on pre-packed foods contained higher proportion of unpacked products – especially raw fruits and meats, i.e. with no FoPL –, compared to participants purchasing with no label (difference of 5.93 percentage points [3.88–7.99], p-value< 0.0001) or with the Reference Intakes (difference of 5.27[3.25–7.29], p-value< 0.0001). This higher proportion was partly explained by fewer purchases of pre-packed processed and ultra-processed products overall in the Nutri-Score group. Conclusions These findings provide new insights on the positive effect of the Nutri-Score, which appears to decrease purchases in processed products resulting in higher proportions of unprocessed and unpacked foods, in line with public health recommendations.