Efficacy of "High in" Nutrient Specific Front of Package Labels-A Retail Experiment with Canadians of Varying Health Literacy Levels.

Elizabeth D Mansfield,Dominique Ibanez,Emily Chen,Elaine De Grandpré,Fuqi Chen

doi:10.3390/nu12103199

Abstract

Background: In 2018, Health Canada, the Federal department responsible for public health, put forward a regulatory proposal to introduce regulations requiring a “High in” front-of-package label (FOPL) on foods that exceed predetermined thresholds for sodium, sugars, or saturated fat. This study evaluated the efficacy of the proposed FOPL as a quick and easy tool for making food choices that support reduction in the intakes of these nutrients. Methods: Consumers (n = 625) of varying health literacy levels (HL) were assigned to control (current labeling with no FOPL) or one of four FOPL designs. They completed six shopping tasks, designed to control for internal motivations. Efficacy was measured with correct product selection and response time (seconds) to make food choices using repeated measures statistical modeling, adjusting for HL, task type, and task order. Eye-tracking and structured interviews were used to gather additional insights about participants’ choices. Results: Overall, FOPL was significantly more effective than current labeling at helping consumers of varying HL levels to identify foods high in nutrients of concern and make healthier food choices. All FOPL were equally effective. Conclusions: “High in” FOPL can be effective at helping Canadians of varying HL levels make more informed food choices in relation to sugars, sodium, and saturated fat.

Highlights

Chronic disease is a major public health concern [1] and unhealthy diets with high levels of sodium, sugars, saturated and trans fats are one of the top risk factors for this chronic disease burden in Canada [2]
While federally regulated nutrition labeling on foods [3] is a key source of nutrition information to make informed food choices [4], many Canadians face challenges in accessing, understanding, and evaluating food label information [5,6] and identifying if a food is high in nutrients of public health concern [7]
It has been suggested that further labelling measures are needed to help protect Canadians from the risks of chronic diseases related to excess consumption of foods high in nutrients of public health concern [5,8], in particular those that may be disadvantaged by risks of limited health literacy [9]

Summary

Introduction

Chronic disease is a major public health concern [1] and unhealthy diets with high levels of sodium, sugars, saturated and trans fats are one of the top risk factors for this chronic disease burden in Canada [2]. In 2016, the World Health Organization (WHO) recommended implementing interpretive front-of-package labeling (FOPL) systems using symbols and nutrient criteria to indicate that a product has certain nutritional characteristics [10]. These FOPL systems offer consumers a simplified. Nutrients 2020, 12, 3199 and visible indicator to help consumers make informed food choices, among those who are limited by time, nutrition knowledge and health literacy (HL) [9,11,12]. In 2018, Health Canada, the Federal department responsible for public health, put forward a regulatory proposal to introduce regulations requiring a “High in” front-of-package label (FOPL) on foods that exceed predetermined thresholds for sodium, sugars, or saturated fat. Efficacy was measured with correct product selection and response time (seconds) to make food choices using repeated measures statistical modeling, adjusting for HL, task type, and task order.

Objectives

Results

Discussion

Conclusion