Front-of-package Labels Research Articles

Analysis of the moderating effect of front-of-pack labelling on the relation between brand attitude and purchasing intention

Nutritional labelling is an instrument to generate eating patterns. The establishment of means to support nutritional labelling is encouraged via a Front-of-Pack (FOP) labelling which facilitates consumers’ comprehension and improves their choices. The aim of this work is to establish the impact that FOP labelling has on the relation between brand attitude and purchase intention, as well as to determine the effect of gender on these relations. Two surveys have been done. The first (129 responses) analyzes the relation between brand attitude and purchase intention without the presence of FOP labelling. The second (111 respondents) presents the FOP labelling. Multigroup analysis establishes the existence of differences in the relation between brand attitude and purchase intention due to the existence of FOP labelling in the case of the male sample. The effectiveness of FOP labelling is conditioned by the consumers’ brand attitudes and by the impact of gender.

Competitive Effects of Front-of-Package Nutrition Labeling Adoption on Nutritional Quality: Evidence from Facts Up Front–Style Labels

“Facts Up Front” nutrition labels are a front-of-package (FOP) nutrition labeling system that presents key nutrient information on the front of packaged food and beverage products in an easy-to-read format. The authors conduct a large-scale empirical study to examine the effect of adoption of FOP labeling on products’ nutritional quality. The authors assemble a unique data set on packaged food products in the United States across 44 categories over 16 years. By using a difference-in-differences estimator, the authors find that FOP adoption in a product category leads to an improvement in the nutritional quality of other products in that category. This competitive response is stronger for premium brands and brands with narrower product line breadth as well as for categories involving unhealthy products and those that are more competitive in nature. The authors offer evidence regarding the role of nutrition information salience as the underlying mechanism; they also perform supplementary analyses to rule out potential self-selection issues and conduct a battery of robustness checks and falsification tests. The authors discuss the implications of the findings for public policy makers, consumers, manufacturers, and food retailers.

Junk food advocacy. Countering the industry

Abstract Background The junk food and alcohol industries have taken a page from the tobacco industry play book in an attempt to resist regulation through delay, self-regulation and effective lobbying. The junk food industry internationally is constantly seeking to increase sales at a time when the obesity crisis continues to grow. The industry thrives through widespread marketing with a particular focus on children. Methods An assessment of the number of lobbyists engaged to influence members of Parliament in Australia is being conducted to understand attempts to influence policy. This follows a scan of the lobbyists' register by Daube et al in 2018 that found the junk food industry had 33 direct and 13 indirect lobbyists. A re-examination of the register in 2020 is expected to reveal an increase in these numbers as international junk food companies become more concerned about regulation by government in areas such as front of pack labelling and marketing. There will also be an examination of the State and Territory registers in an attempt to understand the extent of influence in all governments across Australia. Discussion This examination is focused on the Australian Parliament/s. However, the message will be similar world-wide. Many companies have been challenged about their approaches to marketing and the sales of junk food. However, despite some attempt at corporate responsibility (Ronald McDonald House), they continue to sell their products to the detriment of community health. Presentation The presentation will focus on the importance and methods of countering the efforts of industry to increase availability of junk food by opposing regulation. It will also provide a series of steps that public health advocates can take in order to persuade governments of the importance of protecting community health through appropriate regulation of the marketing and sales of junk food. Key messages Junk food industry employs multiple lobbyists to resist regulatory reform. There are tools available for public health advocates to counter this influence.

The Effect of Dynamic Food Labels with Real-Time Feedback on Diet Quality: Results from a Randomized Controlled Trial.

The rising prevalence of non-communicable diseases has brought attention to the importance of consuming a healthy diet. One strategy to improve diet quality is through front-of-pack (FOP) nutrition labels. Taking advantage of an online grocery store, we allowed consumers to choose the FOP labels they preferred, and combined this information with real-time feedback on the overall nutritional quality of the shopping basket. We hypothesized that these dynamic food labels with real-time feedback (DFLF) would improve nutritional quality of food purchases. This trial followed a two-arm (no-label control and DFLF) crossover design with 125 participants exposed to each condition once in random order via an online grocery store. A first difference regression model allowed for estimating the unbiased effect of the DFLF on diet quality, measured by the weighted average Nutri-Score (ranging 1 to 5) per serving (primary) and changes in select nutrients and calories. The mean weighted Nutri-Score was 0.4 (12.6%) higher in the DFLF arm (CI: [0.2, 0.6]) relative to the control. The DFLF also decreased the amount of sugar per serving by 0.9 g (CI: [−1.7, −0.0]) and total sugar per shop by 169.5 g (CI: [−284.5, −54.5]). The DFLF features significantly improved nutrition quality relative to no labelling, as measured by average Nutri-Score values. These results shed light on the considerable potential of the online shopping environment to improve diet quality through customization and real time feedback.

Development of Criteria for a Positive Front-of-Package Food Labeling: The Israeli Case.

Efforts to shape the food environment are aimed at reducing diet-related co-morbidities. Front-of-package labeling (FOPL) may support the consumers to make an informed decision at the point of purchase and encourage industry to reformulate food products. The Israeli Ministry of Health (MOH) implemented a unique FOPL system, using two colors: A mandatory warning (red) label alongside a voluntary positive (green) label. An independent Scientific Committee, from academia, the healthcare system, and MOH was appointed to determine the core principles for the positive FOPL. The criteria were based on the Mediterranean diet principles, with adjustments to the Israeli dietary habits, focusing on the health advantages of the food and considering its processing level. The food products eligible for positive FOPL are foods in their natural form or with added spices or herbs, or those that underwent minimal processing, with no food additives. Based on population consumption data, 19.8% of food products were eligible for positive FOPL; of them, 54% were fruits and vegetables, 20% dairy, and 14% grains. An evaluation plan is needed to assess the degree of acceptance of the positive FOPL by the industry, retailers, and the public, and its impact on food consumption and on public health.

Nutrient Profiling Systems, Front of Pack Labeling, and Consumer Behavior.

Guiding consumers toward more healthful food choices may help address the high prevalence of poor dietary quality and diet-related diseases. The use of front-of-package labels (FOPL) on food items is expanding to provide focused nutritional information or representations, often based upon nutrient profiling systems. FOPL provide a source of nutrition and health information that is readily understood by consumers, including those with limited literacy. There is evidence that FOPL can shift consumer behavior toward more nutritious and healthful choices. However, assessments of the effectiveness of FOPL have been restricted in scope and rely largely on simulation models rather than real-world environments. FOPL are a direct source of nutritional guidance at the point-of-purchase and provide an opportunity to convey critical information on ingredients that are associated with health promotion and/or increased risk of non-communicable diseases. However, limited evidence regarding the most effective forms of FOPL to achieve behavior change and challenges from the food industry impedes the establishment of standardized nutrient profiles and algorithms. Future opportunities for FOPL include the potential for integrating nutritional profiles with non-nutrient factors affecting health such as food processing and environmental sustainability.

Bulgarian consumers\u2019 objective understanding of front-of-package nutrition labels: a comparative, randomized study

BackgroundBulgaria continues to lag behind other EU Member States with respect to chronic disease morbidity and mortality prevention.MethodsIn line with efforts targeting the improvement of dietary practices, this comparative study assessed objective understanding of five different front-of-package labels (FOPL) (Reference Intakes, Multiple Traffic Lights, Warning label, Nutri-Score, and Health Star Rating) in a sample of 1010 Bulgarian adults. Objective understanding was assessed by comparing the results of two nutritional quality ranking tasks (with and without FOPL) in an online randomized experiment featuring three food categories (pizza, cakes, breakfast cereals). Multivariable ordinal logistic regression models within and across food categories were fit.ResultsCompared with the Reference Intakes group, participants randomized to Nutri-Score exhibited the largest improvement in product ranking ability across food categories (OR = 2.33; 95% CI: 1.55–3.51), followed by those randomized to Health Star Rating (OR = 1.99; 95% CI: 1.32–3.00). Nutri-Score also performed best within two (pizza and breakfast cereals) of the three food categories. The Multiple Traffic Lights and Warning label groups did not display any significant improvement in objective understanding either within or across food categories compared with the Reference Intakes group.ConclusionNutri-Score, which is a summary, interpretive, polychromatic FOPL, emerged as the most effective model in the Bulgarian context, with the potential to help consumers better understand the nutritional quality of food. The findings are of particular interest to public health policymakers in the region and across Europe, as the debate about an EU-wide FOPL model continues to gather momentum.Trial registrationRegistration number ACTRN12618001221246. Trial registered at the Australian New Zealand Clinical Trials Registry.

Role of different nutrient profiling models in identifying targeted foods for front-of-package food labelling in Brazil.

To compare the degree of strictness and agreement of different nutrient profiling models (NPM) used to identify which foods would be required to show front-of-package (FOP) warning labels. Using data of 11434 packaged foods found in the five largest food retailers in Brazil, we used two published NPM: the Pan American Health Organization (PAHO) model and the NPM used in the Chilean nutritional FOP labelling policy, and compared them with a NPM proposed by the Brazilian National Health Surveillance Agency (Anvisa). The proportion of foods that would be required to show FOP warning labels was calculated overall and by food category. We also tested whether a modified version of the PAHO NPM would behave similarly to the original version. Brazil. Two-thirds of the packaged products (62 %) would receive FOP warning labels under the PAHO NPM, as compared with 45 % of products using the proposed Anvisa NPM and 41 % if the Chilean NPM was applied. The PAHO NPM identified more foods high in critical nutrients such as sweetened dairy and non-dairy beverages, canned vegetables and convenience foods. Overall agreement between models was considered good with kappa coefficient ranging from 0·57 to 0·92 but was lower for some food categories. We found variations in the degree of strictness and agreement between assessed NPM. The PAHO NPM identified more foods and beverages high in sugar which are among the top contributors to sugar and energy intake in Brazil.

Are the Nutrient and Textural Properties of Australian Commercial Infant and Toddler Foods Consistent with Infant Feeding Advice?

Abstract Objectives Australian Infant Feeding Guidelines recommend first foods be iron rich with no added sugars and that nutrient poor discretionary foods be avoided. They also encourage exposing infants to a variety of foods and flavours with increasingly complex textures. Here, we compare nutritional and textural properties of commercially available infant and toddler foods with established guidelines. Methods Infant and toddler food products available as of August 2019 were identified by searching for ‘baby food’ on retailer websites and by location in the ‘baby food’ section of major supermarket chains (Coles, Woolworths, Aldi and Foodland) in Adelaide, South Australia. Manufacturer websites were cross checked to identify all available products. Nutrient composition of foods was obtained from the nutrient information panel on the product label, manufacturer or retailer websites. In total, 446 products from 17 brands were reviewed, which accounted for over 90% of the market share. Results Most products were poor sources of iron, and 80% of first foods were fruit-based. Half of all products were purees in squeeze pouches and one third of all products were discretionary foods. The nutritional content of many products was inconsistent with guidelines, being low in iron, sweet, smooth in consistency, or classified as discretionary. Conclusions Reformulation of products is warranted to improve iron content, particularly in mixed main dishes, expand the range of vegetable only foods, and textural variety. Greater regulatory oversight and front of package labelling are needed to better inform parents and caregivers. Frequent consumption of commercial baby foods low in iron may increase risk of iron deficiency. Excessive consumption of purees via squeeze pouches may also have implications for overweight and obesity risk. Funding Sources There are no funding sources to declare for this research.

Process and Method for Implementation of Automated Nutrient Profiling Reporting for a Global Food and Beverage Portfolio

Abstract Objectives With the increasing need for dynamic and flexible nutrient profiling of foods and beverages, PepsiCo has expanded capabilities to report on global nutrition data for business guidance and reporting to regulatory and health agencies. Additional processes were established to integrate nutrition and finance information and influence the long-term data strategy needs of the organization. Methods A multidisciplinary team of nutrition science, finance and IT professionals was assembled to systematically collect and link nutritional and financial data. A controlled, centralized database was created with data from 2015 to present from multiple data sources. Data quality is reviewed quarterly. Dashboards, scorecards and other reporting outputs were created (Tableau software, 2019.02) with end-user input, to measure performance against country-specific regulations, Front-of-Pack (FOP) labeling requirements and internal nutritional guidelines. Results Nutrition data from > 40,000 products are captured annually and linked with sales volume data. There was a 2.5-fold increase in countries contributing data since 2015 (10 vs 26 markets), representing >80% of the company's annual food/beverage sales volumes. Current reports focus on analyzing nutrients-to-encourage (protein, fiber, specific vitamins and/or minerals), food-groups-to-encourage (fruits, vegetables, whole grains, fat-free/low-fat dairy and nuts/seeds/legume) and nutrients-to-limit (saturated fat, sodium, added sugars, trans-fat). Dashboards are currently utilized by 9 company functions, supporting several requests, including national nutrition regulations (n = 2 dashboards), FOP labeling systems (n = 2), retail store requirements (n = 1), internal sustainability goals (n = 3) and customized reports (n = 40). Across all iterations, dashboards have received >1000 views. Conclusions Automated nutrient profiling has been successfully implemented by a multidisciplinary team. Dashboards provide end-users with a timely and efficient tool to dynamically analyze PepsiCo's product portfolio guiding short- and long-term business decisions. Future work includes informing opportunities to improve the nutrient profile of PepsiCo's portfolio and increasing data availability and analysis. Funding Sources PepsiCo Inc.

An Experimental Comparison of the Impact of 'Warning' and 'Health Star Rating' FoP Labels on Adolescents' Choice of Breakfast Cereals in New Zealand.

This research investigated the performance of the red, octagonal Vienna Convention traffic ‘STOP’ sign as a front of pack (FoP) warning nutritional label. While the Vienna Convention traffic light system is an established FoP label, the potential of the ‘STOP’ sign in the role has not been investigated. The performance of the ‘STOP’ label was compared with that of a single star (low nutritional value) Australasian Health Star Rating (HSR) label using a fractionally replicated Latin square design. The labels were presented on choice diads of cold breakfast cereal packets. The sample of 240 adolescents aged 16–18 was drawn from a secondary school in the South Island of New Zealand. A large and significant main effect was observed at the p < 0.01 level for the difference between the ’STOP’ sign and the control condition (no nutritional FoP label), and at p < 0.05 for the difference between the HSR and the ‘STOP’ label. There was no significant difference between the HSR FoP and the control condition. A significant non-additivity (interaction) (p < 0.01) was also observed via the fractional replication. The results indicate that the Vienna Convention ‘STOP’ sign is worthy of further research with regard to its potential as an FoP nutritional label.

Front of pack nutritional labelling schemes: a systematic review and meta-analysis of recent evidence relating to objectively measured consumption and purchasing.

Front of pack labelling (FOPL) provides visible nutritional information and appears to influence knowledge and reformulation. However, a recent Cochrane review found limited and inconsistent evidence for behaviour change. The present review aimed to examine studies published subsequent the Cochrane review, focusing on prepackaged foods, examining the impact of FOPL on purchasing and consumption. Controlled experimental/intervention and interrupted time series (ITS) studies were included, with no age/geography restrictions. Exposures were FOPL with objectively measured consumption/purchasing outcomes. Thirteen databases were searched (January 2017 to April 2019) and forward citation searching was undertaken on the included studies. Purchasing data from experimental studies were meta-analysed. Two series of meta-analyses were undertaken; combined FOPL versus no-FOPL and specific FOPL scheme versus no-FOPL. Outcomes were sugar (g 100g-1 ), calories (kcal 100g-1 ), saturated fat (g 100g-1 ) and sodium (mg 100g-1 ). We identified 14 studies, reporting consumption (experimental; n=3) and purchasing (n=8, experimental; n=3, ITS). Meta-analysis of experimental studies showed sugar and sodium content of purchases was lower for combined FOPL versus no-FOPL (-0.40g sugar 100g-1 , P<0.01; -24.482mg sodium 100g-1 , P=0.012), with a trend for lower energy and saturated fat (-2.03 kcal 100g-1 , P=0.08; -0.154g saturated fat 100g-1 , P=0.091). For specific FOPL, products purchased by 'high in' FOPL groups had lower sugar (-0.67g sugar 100g-1 , P≤0.01), calories (-4.43 kcal 100g-1 , P<0.05), sodium (-33.78mg 100g-1 , P=0.01) versus no-FOPL; Multiple Traffic Light had lower sodium (-34.94mg 100g-1 , P<0.01) versus no-FOPL. Findings regarding consumption were limited and inconsistent. FOPL resulted in healthier purchasing in ITS studies. This review provides evidence from experimental and 'real-life' studies indicating that FOPL encourages healthier food purchasing. PROSPERO CRD42019135743.

Impact of sugar taxes and front-of-package nutrition labels on purchases of protein, calcium and fibre

Taxes and front-of-package (FOP) labels can be effective interventions for reducing consumption of sugar, saturated fat, and sodium; however, few studies have examined their impact on intake of ‘positive’ nutrients. The current study explored the impact of sugar taxes and FOP labels on the protein, calcium and fibre density of snack food purchases. A total of 3584 Canadians aged 13 years and older participated in an experimental marketplace using a 3 × 8 between-within group experiment. Participants received $5 and viewed images of 20 snack food products available for purchase. Participants were randomized to one of five FOP label conditions (no label, high in, multiple traffic light, health star rating, or nutrition grade) and completed three within-subject purchasing tasks with different sugar tax conditions (no tax, 20%, tiered). Upon conclusion, participants received the product and any change from one of the purchasing tasks. The results indicate that participants purchased snack foods with higher fibre density when either sugar tax was applied (+0.1 g/100 kcal) compared to no tax, and when they were assigned to see the multiple traffic light (+0.4 g/100 kcal) or health star rating (+0.3 g/100 kcal) FOP labels, compared to no FOP label. There were no significant differences in the protein or calcium density of snack foods purchased across the tax or FOP labelling conditions. Overall, the findings suggest that as consumers respond to tax or labelling policies by moving away from sugars, sodium, and saturated fat, there may be no downside—or even an increase—in ‘positive’ nutrient density.

The influence of a front-of-pack nutrition label on product reformulation: A ten-year evaluation of the Dutch Choices programme

Front-of-pack (FoP) labels are regarded as helpful tools to stimulate healthier product reformulation as they are based on nutrient criteria that products should comply with in order to obtain the label. Some FoP labelling programs revise criteria periodically. This is the first study investigating the impact of criteria revisions on product compositions over time. Nutrient contents of 4,343 products, including 27 basic and non-basic product (sub) categories with the Dutch Choices Logo were analysed between 2006 and 2016. The number of labelled products increased over time. Sodium and trans-fat contents reduced significantly in 10 and 11 product categories, respectively. Energy, saturated fat and added sugar decreased significantly whilst fibre increased in 4–6 product categories. Overall, labelled products had healthier compositions and more favourable trends in nutrient content compared with products generally on the Dutch market. The results of this study suggest an important role for FoP labels in product reformulation.

Experimental Studies of Front-of-Package Nutrient Warning Labels on Sugar-Sweetened Beverages and Ultra-Processed Foods: A Scoping Review.

Policies that require front-of-package (FoP) nutrient warnings are becoming increasingly common across the globe as a strategy to discourage excess consumption of sugary drinks and ultra-processed food. However, a better understanding of the pathway through which FoP nutrient warnings work, as well as a review of how outcomes being measured in recent studies map onto this pathway, are needed in order to inform policy on the most effective FoP label design for reducing purchases of ultra-processed foods. This scoping review describes a conceptual model for how FoP nutrient warnings affect consumer behavior, examines which of these outcomes are currently being measured, and summarizes evidence from randomized controlled experiments. Twenty-two studies which experimentally tested nutrient warnings against a control label or other labeling systems were included for full-text review. Our conceptual model includes attention; comprehension, cognitive elaboration, and message acceptance; negative affect and risk perception; behavioral intentions, and behavioral response, along with other elements such as external factors and interpersonal communications. We found that many studies focused on outcomes such as attention, comprehension, and behavioral intentions, but considerable gaps in the evidence remain, particularly for intermediary steps on the pathway to behavioral change, such as negative affect and social interactions. FoP nutrient warnings were visually attended to by consumers, easy to understand, helped consumers identify products high in nutrients of concern, and discouraged them from purchasing these products, although other labeling systems were perceived as containing more information and performed better at helping consumers rank the healthfulness of products. More research is needed to understand whether and how nutrient warnings work in the real world to discourage consumer purchases of sugary drinks and ultra-processed food.

Influence of front-of-pack labelling and regulated nutrition claims on consumers’ perceptions of product healthfulness and purchase intentions: A randomized controlled trial

Mandatory front-of-pack (FOP) labelling was proposed in Canada to highlight foods with high contents of sugars, sodium and/or saturated fats, which would be displayed on labels along with the mandatory Nutrition Facts table and voluntary nutrition claims. In an online survey, participants (n = 1997) were randomized to one of four FOP labelling conditions: 1) control, 2) warning label, 3) health star rating or 4) traffic light labelling. Participants were shown four drinks (a healthier drink with or without a disease risk reduction claim, a healthier drink with or without a nutrient content claim, a less healthy drink with or without a disease risk reduction claim and a less healthy drink with or without a nutrient content claim) in random order and one at a time. Participants rated perceived product healthfulness and purchase intentions using a 7-point Likert scale. Participants could access the Nutrition Facts table while viewing labels. Results showed less healthy drinks displaying any FOP labelling were perceived as less healthy compared to the control. In healthier drinks, health star rating and traffic light labelling created a ‘halo’ effect, which was not observed with warning labels. Similar results were observed with purchase intentions. Drinks displaying a disease risk reduction claim were perceived as healthier than those without (p < 0.001) regardless of product's healthfulness. The effect of a nutrient content claim was not significantly different. The effect of FOP labelling and claims was mitigated for those who used the Nutrition Facts table. FOP labelling was likely helpful for consumers with different levels of health literacy. Overall, FOP labelling had significantly stronger influence than nutrition claims on consumers' perceptions; however, the effect of each FOP label varied on healthier and less healthy drinks.

Understanding of different front-of-package labels by the Spanish population: Results of a comparative study

Background and objectivesIncreased prevalence of obesity and its comorbidities has shown the need to implement social policies to help curb this trend. Nutritional risk factors are recognized as key drivers of obesity and other chronic diseases in Spain and in other Western countries. Front-of-package labels (FoPLs) are efficient tools to help consumers make healthier choices. To be useful in purchasing situations, consumers need to understand the information provided by FoPLs. The study objective was to assess objective understanding by consumers of five types of FoPLs, i.e. Health Star Rating system (HSR), Multiple Traffic Lights (MTL), Nutri-Score, Reference Intakes (RIs), and Warning symbol in Spain. MethodsIn 2018, 1000 Spanish participants were recruited and requested to rank three sets of label-free products (one set of three pizzas, one set of three cakes, and one set of three breakfast cereals) according to their nutritional quality in an on-line survey. Participants were then randomized to one of the five types of FoPLs, and were requested to rank the same sets of products again, this time with a given FoPL displayed on the package. Changes in ability to correctly rank products according to FoPLs were compared between both tasks using ordinal logistic regression. ResultsFor all three food categories, Nutri-Score performed significantly better, followed by MTL, the Warning symbol, HSR and RIs. ConclusionsNutri-Score emerged as the most efficient FoPL in conveying information on the nutritional quality of foods among Spanish consumers.

Nutri-Score, multiple traffic light and incomplete nutrition labelling on food packages: Effects on consumers’ accuracy in identifying healthier snack options

Front-of-package (FOP) nutrition labels are designed to help consumers evaluate the healthiness of foods and to promote healthier food choices. In this study, an online experiment with Swiss consumers (N = 1313) was conducted to compare the effects of different nutrition label formats on consumers’ evaluations of snack food healthiness. Participants were asked to select the healthier option in 105 pairwise comparisons of 15 salty snacks. The participants were randomly assigned to one of five conditions: the FOP presented with (1) the nutrition facts table, (2) the multiple traffic light (MTL), (3) the Nutri-Score, (4) the Nutri-Score on half of the products, or (5) no nutrition information (control). The consumers’ evaluations of the snacks’ healthiness were fairly accurate, even without being given nutrition information on the packaging. The Nutri-Score led to the greatest accuracy in identifying the healthier of two snacks (when using the British FSA/Ofcom nutrient profiling score to determine product healthiness); however, this had only a minimal effect on the evaluation when only some of the products were labelled. Both FOP labels were superior to the FOP with and without the nutrition facts. This indicates that for maximum effectiveness, the labelling of all available products is needed. The perceived usefulness and public support of mandatory implementation were higher for the MTL than for the Nutri-Score label; however, for the latter, perceived usefulness and public acceptance were higher among the participants who became familiar with the label during the experiment than among those who did not.

Selected Predictors of the Importance Attached to Salt Content Information on the Food Packaging (a Study among Polish Consumers).

This paper aims to identify selected antecedents of the importance attached to salt content information (ISCI) placed on food labels, on the basis of a representative survey of 1051 Polish consumers. The study was conducted with the use of the CAWI (Computer Assisted Web Interviews) method in 2018. Quota sampling was applied with reference to the following five criteria: sex, age, education, place of living (urban and rural areas), and region. In a multiple regression model, ISCI depends on the respondent’s: sex, age, evaluation of the quantity of nutrition claims, importance attached to nutrition claims, willingness to pay a price premium for products with nutrition claims, attention paid to health and nutrition claims, agreeing with the opinion that unreliable nutrition claims are a serious problem, evaluation of healthiness of one’s diet, self-rated knowledge about healthy nutrition, buying organic food, and reading front-of-package (FOP) labels during and after the purchase. The strongest effects on the importance attached to salt content information on the food packaging were displayed by the importance of nutrition claims, attention paid to nutrition and health claims, respondent’s age, FOP label reading at home, and agreeing that the use of unreliable nutrition claims is a serious problem.

The impact of proposed nutrient criteria for the display of mandatory front-of-package ‘high-in’ symbols in the Canadian prepackaged foods supply

AbstractBackground: Front-of-package (FOP) nutrition labelling has become a core component of policy recommendations to address the growing burden of diet-related non-communicable disease globally. The CODEX Committee on Food Labelling is in the process of establishing standardized criteria for the definition of “high-in” for use with FOP labels highlighting excessive amounts of fats, sugars and sodium in foods. Recently, as part of Health Canada's Healthy Eating Strategy, regulations requiring the mandatory display of high-in FOP symbols have been published. The aim of this study was to investigate the extent to which these symbols would appear on foods and beverages in the Canadian prepackaged food supply, both overall and by food category.Methods: Foods and beverages in the University of Toronto's Food Label Information Program database 2013 (n = 15,277) were assessed for the prevalence of products that would have to display a symbol based on criteria published in the draft Canadian regulations. The criteria include thresholds based on the % Daily Value (DV) for each nutrient, above which, products would be required to display a FOP symbol for that nutrient. Exemptions are provided for fruits and vegetables without added sodium, sugars, or saturated fats, non-flavoured whole or partly skimmed milk, eggs, sweetening agents (i.e. sugar, honey, syrups and molasses) and table salt.Results: 61.7% (n = 10,251) of products would be required to display at least one symbol. Of these, 52.3% (n = 5,358) would have a sodium symbol, 41.9% (n = 4,295) a saturated fats symbol and 41.0% (n = 4,207) a sugars symbol. Overall, 37% of products would display a symbol for more than one nutrient. The highest concentration of symbols were found on processed meats (93.8%), soups (93.0%), desserts (87.2%), sugars and sweets (82.3%), dairy (76.9%) and bakery products (71.0%).Discussion: This is the first study to evaluate the impact of proposed regulations for the mandatory display of FOP symbols on Canadian prepackaged foods. Findings identify a high concentration of symbols in categories contributing meaningfully to dietary sodium, sugars, and saturated fats intakes, but also in categories for which consumption is discouraged in national dietary guidelines (e.g. processed meats, desserts). The findings presented here will inform ongoing discussions on how best to optimize criteria underpinning the display of FOP “high-in” labels.