Abstract
Front-of-package labeling (FOPL) is a policy tool that helps consumers to make informed food choices. South Africa has not yet implemented this labeling system. The aim of this study was therefore to explore adult South African consumers' perceptions of front-of-package warning labels on foods and non-alcoholic beverages (referred to as drinks in this paper) and their insights into features that could influence the effectiveness of the warning label. Using a qualitative approach, the study purposively selected consumers diversified by urbanization, gender, socioeconomic status, and literacy. We collected data from a total of 113 participants through 12 focus group discussions. Data were systematically coded and divided into five themes namely, positive attitudes toward warning labels, perceived benefits of warning labels, perceived behavior modification, perceived beneficiaries of warning labels, and effective attributes of warning labels. Almost all participants from all socio-economic backgrounds were positive about warning labels, reporting that warning labels concisely and understandably educated them about the nutritional composition of foods. Other perceived advantages were that warning labels warn of health implications, are easily understandable and could benefit child health. Some participants anticipated that warning labels would reduce their purchases of unhealthy foods, while others thought the labels would have no effect on their purchasing habits. Participants found the warning labels attention grabbing and stated that they preferred a black triangle placed on a white background (referred to as a holding strap henceforth), the words "high in" and "warning" in bold and uppercase text, an exclamation mark, and an icon depicting the excessive nutrient. In South Africa warning labels may improve consumer understanding of nutrition information and assist consumers in determining the nutritional quality of packaged foods and drinks.
Highlights
The global prevalence of overweight and obesity is high [1, 2] and South Africa is no exception [3, 4]
This study found that adult South African consumers had a positive attitude toward warning labels on ultra-processed foods and drinks
Study participants felt that warning labels are easy to understand, provide important nutrition information, and could save shopping time
Summary
The global prevalence of overweight and obesity is high [1, 2] and South Africa is no exception [3, 4]. The prevalence of noncommunicable diseases (NCDs), such as hypertension and diabetes, is increasing annually in low- and middle-to-high-income countries, including South Africa [4, 6]. Several reports have demonstrated a link between high consumption of ultra-processed foods and drinks and the development of obesity and NCDs [9,10,11]. In other studies South African adults have reported very high sodium intakes due to consumption of processed food, including ultra-processed food [4, 12]
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