Abstract
The ability to use serving size information on food labels is important for managing age-related chronic conditions such as diabetes, obesity and cancer. Past research suggests that older adults are at risk for failing to accurately use this portion of the food label due to numeracy skills. However, the extent to which older adults pay attention to serving size information on packages is unclear. We compared the effects of numeracy and attention on age differences in accurate use of serving size information while individuals evaluated product healthfulness. Accuracy and attention were assessed across two tasks in which participants compared nutrition labels of two products to determine which was more healthful if they were to consume the entire package. Participants' eye movements were monitored as a measure of attention while they compared two products presented side-by-side on a computer screen. Numeracy as well as food label habits and nutrition knowledge were assessed using questionnaires. Sacramento area, California, USA, 2013-2014. Stratified sample of 358 adults, aged 20-78 years. Accuracy declined with age among those older adults who paid less attention to serving size information. Although numeracy, nutrition knowledge and self-reported food label use supported accuracy, these factors did not influence age differences in accuracy. The data suggest that older adults are less accurate than younger adults in their use of serving size information. Age differences appear to be more related to lack of attention to serving size information than to numeracy skills.
Highlights
We examined the strength of evidence for the competing hypotheses that numeracy v. attention to serving size information is a better predictor of accurate use of serving size information, with specific attention to how their effects on accuracy change with age
We used mixed-effects logistic regression models to test for associations between accuracy and key personal characteristics and trial characteristics
Serving size information on nutrition labels is important for older adults seeking to manage diet-related chronic conditions
Summary
Understanding of, serving size information within a sample of adults aged 20–80 years. Questionnaires including demographic questions, self-reported food label use, numeracy and nutrition knowledge were completed at the beginning of session 1 For both serving size tasks, participants viewed highresolution images of the package fronts, presented side by side, on a wide-screen monitor while their eye movements were monitored. We used mixed-effects logistic regression models to test for associations between accuracy (odds of choosing the more nutritious option in a trial) and key personal characteristics (age in years as a continuous variable, education, income, nutrition knowledge, numeracy and self-reported food label use) and trial characteristics (inconsistency, task and how much attention was paid to the labels in that trial). Our first multivariate model included age × task and age × inconsistency interactions to see whether age differences, if found, were associated with trial characteristics (the more specific instructions in Task 2, or having inconsistent per-serving and per-package nutrition information). Analyses were performed using the statistical software package SAS® version 9.4
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