A Randomized Controlled Trial Evaluating the Relative Effectiveness of the Multiple Traffic Light and Nutri-Score Front of Package Nutrition Labels.

Eric A Finkelstein,Brett Doble,Rob M Van Dam,Wei Han Melvin Wong,Felicia Jia Ler Ang

doi:10.3390/nu11092236

Eric A Finkelstein, Brett Doble + Show 3 more

Open Access

https://doi.org/10.3390/nu11092236

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Abstract

The objective of this trial was to test two promising front-of-pack nutrition labels, 1) the United Kingdom’s Multiple Traffic Lights (MTL) label and 2) France’s Nutri-Score (NS), relative to a no-label control. We hypothesized that both labels would improve diet quality but NS would be more effective due to its greater simplicity. We tested this hypothesis via an online grocery store using a 3 × 3 crossover (within-person) design with 154 participants. Outcomes assessed via within person regression models include a modified Alternative Healthy Eating Index (AHEI)-2010 (primary), average Nutri-Score, calories purchased, and singular measures of diet quality of purchase orders. Results show that both labels significantly improve modified AHEI scores relative to Control but neither is statistically superior using this measure. NS performed statistically better than MTL and Control based on average Nutri-Score, yet, unlike MTL it did not statistically reduce calories or sugar from beverages. This suggest that NS may be preferred if the goal is to improve overall diet quality but, because calories are clearly displayed on the label, MTL may perform better if the goal is to reduce total energy intake.

Highlights

All nations have seen a significant upward trend in obesity rates over the past several decades, putting populations at increased risk for weight-related chronic diseases and premature mortality [1,2,3,4,5,6,7,8].As a result, interventions aimed at encouraging healthier food consumption have been pursued by policy-makers worldwide
Data is analyzed from an intention-to-treat approach that conforms to the Consolidated Standards of Reporting Trials (CONSORT) standards for reporting of randomized trials
Our results show that both the Multiple Traffic Lights and Nutri-Score labeling scheme employed led to statistically significant improvements in diet quality relative to no-labelling based on mean modified AHEI-2010 scores and average Nutri-Score

Summary

Introduction

Interventions aimed at encouraging healthier food consumption have been pursued by policy-makers worldwide. The country of focus for this study, is no exception. 1 in 3 adults are overweight and 1 in 9 have diabetes [9]. These are substantial increases from previous decades [10]. To counter these trends, the government is considering several options. One policy under consideration is mandatory front-of-pack (FOP) labeling on nutrition content (www.reach.gov.sg)

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