Front-of-package Labels Research Articles

Exploring Consumer Understanding and Perceptions of Front-of-Pack Labelling of Foods and Non-Alcoholic Beverages in Kenya

Background: Front-of-package labeling (FOPL) is shown to support healthier consumer choices. Many countries have adopted different FOPL systems. Objective: This study explored perceptions and understanding of three FOPLs and identified features that could enhance their effectiveness in Kenya. Methods: A qualitative study was conducted across four Kenyan counties—Nairobi, Mombasa, Garissa, and Kisumu. Data from 12 focus group discussions with 137 adults of diverse socio-demographic backgrounds were analysed. Participants evaluated three FOPLs: Red and Green (RG) Octagon, Red and Green Octagon with icons and text (RGI), and Black Octagon Warning Label (WL). The FGDs assessed visibility and memorability, comprehension, potential effectiveness, and cultural relevance of each label. NVivo version 14.0 was used for thematic analysis. Results: Kenyan consumers had mixed perceptions of the proposed FOPLs. The black Octagon WL was found to be the most visible and memorable due to its bright colours. Although the RG and RGI symbols were visually engaging, some participants reported confusion with the colour meanings. The WL was also more readily understood due to its text. Overall, WL was preferred for its potential to influence purchasing decisions, while all three FOPLs were considered culturally suitable. Conclusions: The Black Octagon Warning Label was the most visible and comprehensible of the three FOPLs and shows promise in influencing consumer behaviour in Kenya. While RG and RGI symbols are appealing, their colour scheme could reduce their effectiveness. Educating consumers on FOPLs could enhance their impact in reducing unhealthy food purchases.

Effectiveness of Three Front-of-Pack Food Labels in Guiding Consumer Identification of Nutrients of Concern and Purchase Intentions in Kenya: A Randomized Controlled Trial

Background: Front-of-pack-labels (FOPLs) on packaged foods provide essential information to help consumers make informed dietary choices. However, evidence on their effectiveness, particularly in low- and middle-income countries like Kenya, is limited. Objective: This study assessed the effectiveness of three FOPLs in helping consumers identify nutrients of concern in packaged food products and influencing their purchase intention in Kenya. Methods: A total of 2198 shoppers from supermarkets in Nairobi, Mombasa, Kisumu, and Garissa were randomized into three groups: Red and Green Octagon label (RG), Red and Green Octagon with icons (RGI), and Black Octagon Warning label (WL). In the control phase, participants were shown unlabeled images of packaged foods, followed by questions. In the experimental phase, the same images were presented with one assigned FOPL, and participants responded again to the same set of questions. Differences in correct identification of nutrients of concern and changes in purchase intention were analyzed using frequency tables and Chi-Square tests, while modified Poisson regression assessed FOPL effectiveness. Results: FOPLs significantly improved correct nutrient identification and reduced the intention to purchase unhealthy foods, with the WL proving most effective. Conclusions: These findings highlight the potential of FOPLs, particularly the WL, as an effective regulatory tool for promoting healthier food choices in Kenya.

Global overview of government-endorsed nutrition labeling policies of packaged foods: a document review

IntroductionNutrition labeling provides nutritional information about nutrients present in a food product. It is commonly applied to packaged foods and beverages, where the information can be presented on the back or front of the pack as the nutrient declaration, nutrition and health claims, and supplementary nutrition information. Nutrition labeling is an important policy instrument for improving the nutritional quality of foods and promoting healthy diets, as it allows consumers to make informed purchasing decisions. This document review aims to provide a comprehensive overview of government-endorsed nutrition labeling policies related to nutrient declaration, nutrition claims, and supplementary nutrition information enforced worldwide.MethodsWe searched two nutrition policy databases, the Global database on the Implementation of Food and Nutrition Action (GIFNA) and the NOURISHING database, and government websites of some selected countries for the government-endorsed nutrition labeling policies published up to June 2023. We narrated the policy adopting countries' distribution by WHO regions, mode of implementation (voluntary or mandatory), and types of front-of-pack labels implemented.ResultsGlobally, we found that 95 countries have mandatory policies for nutrient declarations on packages of processed products. These include 41 countries in Europe, 19 in America, 14 in the Western Pacific, nine in Africa, seven in the Eastern Mediterranean region, and five countries from South-East Asia. Additionally, 71 countries have policies on the use of nutrient claims like “fat-free,” “excellent source,” and “fortified.” European region has the highest number of countries (37) that have rules on nutrient claims. Front-of-pack labeling (FOPL) policies have been introduced in 44 countries as supplementary nutrition information. Of these, 16 countries have adopted FOPL as mandatory, while others have implemented it voluntarily. The FOPL systems include warning labels, keyhole logo, health star rating, traffic light labeling, nutri-score, and healthy choice logos.ConclusionOver recent years, the number of countries adopting mandatory nutrition labeling policies, especially FOPLs, has increased globally. Labeling policies should be evidence-based and follow the best practices to protect consumers from unhealthy nutrients and promote healthy eating. FOPL designs need to be selected based on country-specific evidence of effectiveness and appropriateness, avoiding industry influence.

Can Front-of-Pack Labeling Encourage Food Reformulation? A Cross-Sectional Study on Packaged Bread

Front-of-pack labeling (FOPL) may represent an important instrument for the food industry in the promotion of food product reformulation. The present cross-sectional study used salt reduction in packaged breads as a case study, aiming to investigate whether two different types of FOPL (i.e., Nutri-Score (NS) and NutrInform battery (NIB)) can capture food reformulation and thus be effective tools for encouraging reformulation. The Nutri-Score and NIB were calculated by consulting the nutritional declarations and ingredient lists of 527 packaged breads currently sold in Italy before and after applying three different theoretical reformulation strategies: (i) a 25% salt decrease from the current median salt content in bread; (ii) a reduction of up to 0.825 g/100 g of salt, corresponding to the sodium benchmark of 330 mg/100 g set by the World Health Organization (WHO); and (iii) the minimum salt reduction needed to improve the NS by one grade. The results show that only ~44% of breads had improved NSs when the sodium was lowered to reach the WHO benchmark or when salt was reduced by 25%, whereas large variability was observed in the minimum salt reduction needed to improve the NS. Regarding the NIB, the battery for salt improved when both strategies of reformulation were applied. FOPL is not always effective in capturing food reformulation in terms of salt reduction, possibly discouraging the efforts of food companies to improve the nutritional quality of foods.

Guideline Daily Amount (GDA) outperforms Nutri-Score in assessing healthiness. Case study with breakfast cereals

AbstractNutritional information on packaging is becoming increasingly important in the food industry. Currently, labels are seen not only on the back of the packaging but also on the front. As there are many versions of front-of-pack labels (FoPLs), the research aims to determine which helps consumers the most in making decisions about which food to include in a healthier lifestyle. Nutri-Score, Guideline Daily Amount (GDA) and Multiple Traffic Lights (MTL) FoPLs on cereals were compared using eye-tracking (ET) and choice-based conjoint analysis (CBCA). CBCA was used to assess consumer preferences and the labels and products were also ranked. Based on the results, GDA type FoPL proved to be the most useful based on conjoint analysis, ranking and the analysis of ET parameters. This label helped participants the most in choosing the product that best fits into a healthier lifestyle. The Nutri-Score label, which offers little information on a product's nutritional content, was not favourably received by the Hungarian sample, who preferred more detailed FoP labels.

Evaluating the application of front-of-package labelling regulations to menu labelling in the Canadian restaurant sector using Menu Food Label Information and Price (Menu-FLIP) 2020 data.

To evaluate the application of front-of-package (FOP) labelling regulations to menu labelling in the Canadian restaurant sector by assessing the proportion of menu items that would be required to display the 'high-in' FOP symbol if the policy were extended to the restaurant sector. Nutrition information of 18,760 menu items were collected from 141 chain restaurants in Canada. Menu items were evaluated using the mandatory FOP labelling regulations promulgated in Canada Gazette II by Health Canada in July of 2022. Chain restaurants with ≥20 establishments in Canada. Canadian chain restaurant menu items including beverages, desserts, entrées, sides, and starters. Overall, 77% of menu items in the Canadian restaurant sector would display a 'high-in' FOP symbol. Among these menu items, 43% would display 'high-in' one nutrient, 54% would display 'high-in' two, and 3% would display 'high-in' all three nutrients-of-concern. By nutrient, 52% were 'high-in' sodium, and 24% and 47% were 'high-in' total sugars and saturated fat, respectively. Given the poor nutritional quality of restaurant foods, the current regulations, if applied to restaurant foods, would result in most menu items displaying a FOP symbol. Therefore, expanding the Canadian FOP labelling regulations to the restaurant sector can be key to ensuring a healthy food environment for Canadians. Furthermore, menu labelling along with other multi-faceted approaches such as reformulation targets are necessary to improve the dietary intake of Canadians from restaurant foods.

Evaluation of front-of-pack labeling’s impact on unhealthy food consumption in Israeli households

Abstract Background In 2020, Israel introduced front-of-pack labeling (FOPL), marking unhealthy foods high in sugar/salt/saturated fat in red and Mediterranean diet-conforming foods in green, aiming to facilitate healthy choices through clear nutrition information. Methods Two cross-sectional telephone surveys assessed food purchasing, red/green food consumption frequency, label exposure, and perceived impact before labeling (944 households, 2019) and 3 years post-implementation (500 households, 2023). Results Over 90% of respondents in 2023 reported seeing red labels on packages. Nearly 70% checked for red labels when shopping, vs. only 48% who examined the full Nutrition Facts panel on the back of the package. 60% reported preferring unlabeled alternatives within unhealthy categories. Although 50% reported that compared to the period before the labeling, they purchased fewer red-labeled products, a significant decrease in purchasing rates between timepoints was found only for 2 out of 11 unhealthy food categories-sugary drinks (which during 2022 were also taxed by sugar content) and salty snacks. At both timepoints, rates of purchasing and consumption frequency of unhealthy foods were higher among households with children, compared to other households. Multivariate analysis showed that having children under 18, lower education and bigger household size predicted a higher overall unhealthy consumption score. Red label checking was associated with better scores. Conclusions FOPL raised awareness and shows potential for reducing unhealthy consumption, especially when combined with policies like sugar taxation. Their impact on reducing purchases of nutritionally valueless foods (snacks/sugary drinks) is highly valuable. However, red-labeled food consumption remained high among households with children, a strong predictor of higher unhealthy consumption scores. Continued label promotion, child-targeted interventions, and product reformulation incentives are recommended. Key messages • FOPL shows potential of enhancing healthy choices especially when combined with supportive policies. • Results regarding households with children highlight the need for continued promotion, child-targeted interventions, and product reformulation incentives for impacting long-term habits.

The influence of front-of-pack labelling on consumer decision-making: a comprehensive study using electroencephalography and FaceReader

Front-of-pack labels (FOPL) can influence consumer behaviour in a variety of ways, and companies that prioritise accurate and transparent nutrition labels can see benefits in increased sales and brand loyalty. However, there are several types of FOPL on the market that differ in visual appeal and consumer clarity. The aim of the study was to reveal the impact of the nutrition label Nutri-Score as well as other factors on consumer decision-making when choosing healthier alternatives for selected food types. In addition to traditional research methods such as questionnaires, in-depth interviews, also emerging methods such as eye tracking, FaceReader and electroencephalography were used to collect implicit feedback. Research suggests that there are significant differences between implicit and explicit feedback when examining the impact of Nutri-Score on the decision-making process. Last but not least, the study presents ideas for future research in real-world settings using emerging methods.

Examining the role of industry lobbying on Canadian front-of-pack labelling regulations.

Health Canada recently issued a Marketing Authorization to expand the eligibility of the dairy-related exemption for Canadian front-of-pack labelling (FOPL) regulations. The 2024 Marketing Authorization exempts dairy-related products that are a 'source of calcium,' rather than only 'high in' calcium as previously regulated, from displaying a 'High in' front-of-pack nutrition symbol, regardless of their saturated fat and sodium levels. The Marketing Authorization, heavily influenced by the food industry, lacks strong scientific evidence to support its adoption. Although there is a high prevalence of inadequate calcium intakes among Canadians, the Marketing Authorization will exempt more dairy-related products that are significant contributors of saturated fat and sodium for Canadians. While providing very little calcium, many dairy-related products, particularly cheese products, are 'high in' saturated fat and/or sodium. Expanding the exemption criteria will allow dairy-related products with little health benefits to be reflected as 'healthy' (i.e., not display a 'High in' nutrition symbol), blunting the potential impact that FOPL regulations could have on improving the diets of Canadians. We strongly urge Health Canada to reconsider the expansion of the exemption and encourage others to conduct policy-relevant research and participate in the policy decision-making process to promote evidence-informed public health policies for the health of Canadians.

“Warning: ultra-processed”: an online experiment examining the impact of ultra-processed warning labels on consumers’ product perceptions and behavioral intentions

BackgroundNutrient content and degree of processing are complementary but distinct concepts, and a growing body of evidence shows that ultra-processed foods (UPFs) can have detrimental health effects independently from nutrient content. 10 + countries currently mandate front-of-package labels (FOPL) to inform consumers when products are high in added sugars, saturated fat, and/or sodium. Public health advocates have been calling for the addition of ultra-processed warning labels to these FOPLs, but the extent to which consumers would understand and be influenced by such labels remains unknown. We examined whether the addition of ultra-processed warning labels to existing nutrient warning labels could influence consumers’ product perceptions and purchase intentions.MethodsIn 2023, a sample of adults in Brazil (n = 1,004) answered an open-ended question about the meaning of the term “ultra-processed,” followed by an online experiment where they saw four ultra-processed products carrying warning labels. Participants were randomly assigned to view either only nutrient warning labels or nutrient plus ultra-processed warning labels. Participants then answered questions about their intentions to purchase the products, product perceptions, and perceived label effectiveness.ResultsMost participants (69%) exhibited a moderate understanding of the term “ultra-processed” prior to the experiment. The addition of an ultra-processed warning label led to a higher share of participants who correctly identified the products as UPFs compared to nutrient warning labels alone (Cohen’s d = 0.16, p = 0.02). However, the addition of the ultra-processed warning label did not significantly influence purchase intentions, product healthfulness perceptions, or perceived label effectiveness compared to nutrient warning labels alone (all p > 0.05). In exploratory analyses, demographic characteristics and prior understanding of the concept of UPF did not moderate the effect of ultra-processed warning labels.ConclusionsUltra-processed warning labels may help consumers better identify UPFs, although they do not seem to influence behavioral intentions and product perceptions beyond the influence already exerted by nutrient warning labels. Future research should examine how ultra-processed warning labels would work for products that do and do not require nutrient warnings, as well as examine the benefits of labeling approaches that signal the health effects of UPFs.Trial registrationClinicalTrials.gov, NCT05842460. Prospectively registered March 15th, 2023.

Evaluating Health Canada’s Proposed Front-of-Pack Labelling Policy: Burden of Healthcare Use Attributed to Health Canada’s Proposed Front-of-Pack Labelling Policy

The economic burden of disease due to consumption of poor diet costs billions of dollars annually to the Canadian healthcare system. This project is in response to the growing interest in the use of nutrient profiling systems on front-of-package (FOP) nutrition labels in Canada. There is a high demand for simplified healthy eating messaging. Health Canada announced improving food environments is a priority in the Healthy Eating Strategy and will implement the mandatory FOP label policy in 2026. Two Ontario-based studies examined the impacts of health behaviors (smoking, alcohol consumption, poor diet and physical inactivity) attributed to hospital bed-days and costs. They found 36% of hospital use was attributable to all health behaviours resulting in 900,000 bed-days annually. Between 2004-2013, 22% of healthcare costs totalling $89.4 billion were attributable to the four health behaviours. These are likely underestimates as diet was measured based on fruit/vegetables frequency. The objective is to evaluate Health Canada’s Proposed FOP policy on hospital bed-days. Detailed dietary data from the nationally representative cross-sectional national survey data Canadian Community Heath Survey-Nutrition 2004 linked to Discharge Abstract Database (2004-14) for hospital use will be used for analysis. Data-driven methodology will be employed and development of multivariable risk models using zero-inflated negative binomial regression with multiple exposure groups to test a dose-response. Results are undergoing, will be ready September 2024. This is the first study to analyze Health Canada’s proposed FOP policy related to economic outcomes. These findings will provide evidence-based recommendations to policymakers on nutrition policy.

The Return on Investment for the Prevention and Treatment of Childhood and Adolescent Overweight and Obesity in Beijing: A Modeling Study.

Background: The increasing prevalence of child and adolescent overweight and obesity (CAOAO) in Beijing poses significant health and economic challenges. This study assesses the potential health and economic outcomes of implementing specific interventions to address CAOAO in Beijing. Methods: A deterministic Markov cohort model was used to estimate the impact of five interventions from 2025 to 2115: restrictions on unhealthy food marketing to children, mandatory front of package labeling (FOPL), family-based nutrition and exercise education, school-based nutritional health education, and nutritional counseling in primary healthcare. The model evaluated societal costs, healthcare savings, wages, and economic productivity in adulthood, calculating the return on investment (ROI) for each intervention and their combined effect. Result: Without intervention, Beijing is projected to experience a loss of 13.4 million disability-adjusted life years (DALYs) due to CAOAO. The health and economic impact of childhood obesity in Beijing is projected to be CNY 14.6 trillion (USD 2.1 trillion), or a lifetime loss of CNY 6.8 million (USD 0.96 million) per affected child, exceeding the sum of Beijing's GDP from 2021 to 2023. Restrictions on unhealthy food marketing to children and nutrition counseling in primary healthcare are projected to yield the highest returns, with benefits accruing within one year of implementation. Owing to the substantial upfront costs, including personnel, materials, and training, school-based and family-based interventions require a longer time horizon to realize significant health and economic benefits. Conclusions: Effective management of CAOAO in Beijing demands a multifaceted approach. The combination of restrictions on unhealthy food marketing to children, mandatory front of package labeling, nutrition counseling in primary healthcare, school-based intervention, and family-based intervention presents the most substantial health and economic returns. This comprehensive strategy aligns with global best practices and addresses the unique challenges faced by Beijing in combating childhood obesity.

The Potential Effectiveness of Front-of-Pack Nutrition Labeling for Improving Population Diets.

Nutrition labeling on the front of food packages can support more healthful purchase decisions and encourage favorable reformulation. This systematic literature review applied Cochrane methods to synthesize and appraise the evidence on the effectiveness of front-of-pack labeling (FOPL) on diet-related outcomes and food reformulation to inform policy recommendations. The search was conducted on 11 academic and gray literature databases, from inception to July 2022. Evidence was synthesized using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation), vote counting, and meta-analyses, where appropriate. Overall, 221 articles were included in the review. The randomized controlled trial evidence suggested that, compared with when no FOPL was present, FOPL likely improved consumer understanding of the nutritional quality/content of foods (moderate certainty of evidence), and the healthfulness of food choices (moderate certainty) and purchases (moderate certainty). Interpretive FOPL had a greater effect on these outcomes compared with noninterpretive systems (moderate certainty). There was inconsistency in the best-performing interpretive FOPL system.

Impact of Five Types of Front-of-Package Nutrition Labels on Consumer Behavior among Young Adults: A Systematic Review.

The World Health Organization (WHO) recommends that governments promote and implement front-of-package (FoP) nutrition labels to prevent noncommunicable diseases. Recently, additional research has focused on various views on FoP label creation. However, few review studies have examined how different FoP labels affect young consumer behavior. Therefore, this study thoroughly analyzed the evidence on how FoP labels in five categories affect young consumer purchasing intention and behavior. We searched for keywords in the Web of Science, Scopus, and EBSCO databases and screened study samples according to inclusion and exclusion criteria. Fourteen studies that matched the criteria were included in this review. We discovered that numerous studies support the efficacy of the "graded indicators" category labels, with the "color-coded" and "positive logos" categories trailing closely behind. The effectiveness of the "warning" FoP label category is mixed on consumers' healthy purchasing behavior and intention. The numerical FoP labels were most commonly used to indicate ineffectiveness. Future studies should investigate the effects of FoP labels on various subpopulations and conduct thorough evaluations of the design elements of FoP labels. Also, they should offer evidence-based recommendations, supported by both quantitative and qualitative data, for regions that have not yet implemented FoP labeling systems.

Salt Reduction and Iodine Fortification Policies Are Compatible: Perspectives for Public Health Advocacy.

Cardiovascular diseases account for almost 18 million deaths annually, the most of all non-communicable diseases. The reduction of dietary salt consumption is a modifiable risk factor. The WHO recommends a daily sodium intake of <2000 mg but average consumption exceeds this in many countries globally. Strategies proposed to aid effective salt reduction policy include product reformulation, front of pack labelling, behavioural change campaigns and establishing a low-sodium-supportive environment. Yet, salt for household and processed food use is, in countries wholly or partially adopting a universal salt iodisation policy, the principal vehicle for population-wide iodine fortification. With salt reduction policies in place, there is concern that iodine deficiency disorders may re-emerge. Recognising the urgency to tackle the rising prevalence of NCDs yet not risk the re-emergence and detrimental effect of inadequate iodine intakes, this review lays out the feasibility of integrating both salt reduction and salt iodine fortification strategies. Reducing the burden of health risks associated with an excessive sodium intake or inadequate iodine through population-tailored, cost-effective strategies involving salt is both feasible and achievable, and represents an opportunity to improve outcomes in public health.

The role of Nutri-Score and NutrInform Battery in guiding the food choices of consumers with specific nutritional needs: A controlled study

Background and aimsThere is a significant knowledge gap regarding the effectiveness of front-of-pack labeling (FoPL) systems in helping food choices that meet specific nutritional requirements. This study sought to compare the effectiveness of the Nutri-Score (NS) and NutrInform Battery (NIB) labels in assisting consumers to select food products with low sodium or low saturated fat. Methods and resultsUtilizing a controlled experimental design, a sample of 1512 participants (aged 18–70, 50.8% females) was exposed to scenarios through computer-assisted web interviewing, where they selected food products suitable for people with suboptimal blood pressure or plasma cholesterol levels, labeled with either NS, NIB, or no label (blind). The NIB proved significantly more efficacious than NS in guiding participants towards making selections in better agreement with nutritional needs, for blood pressure or cholesterol control. Furthermore, the NIB was generally viewed more favorably, with participants rating it as more trustworthy, informative, and useful for the required task. Notably, younger participants, those with higher nutritional knowledge, and those less inclined towards intuitive or spontaneous decision-making demonstrated a greater propensity for making health-congruent food choices when using the NIB. ConclusionThe findings suggest that the informative FoPL system, NIB, may offer greater advantages in addressing specific dietary requirements. This underscores the important role of FoPL systems in promoting public health and meeting diverse and specific consumer needs. Further research is needed to confirm these results in broader contexts and for additional health conditions.

Awareness and perception of consumers regarding food labels on packaged foods with special emphasis on front of package labels

Awareness and perception of consumers regarding food labels on packaged foods with special emphasis on front of package labels

Resident Doctors and Food Labelling: A Descriptive Study from India

Abstract Background: Perception of front-of-package label (FOPL) amongst doctors is crucial to sensitise patients towards healthy eating choices using FOPL. This study was conducted to assess knowledge, attitude and practices (KAP) of FOPL amongst resident doctors. Methods: A descriptive study was carried out on 100 resident doctors at Sawai Man Singh Medical College during the period of September–November 2023. KAP regarding FOPL were assessed using validated questionnaire, scored and categorised as per Bloom’s criteria. Results: The study showed a mean KAP score of 8.17 ± 1.95 for the participants, out of maximum score of 15. Participants scored highest in the knowledge (4.07 ± 1.08) and lowest in the practice section (0.90 ± 1.16). Although 99% of respondents were aware about some labelling on packaged food items, only 23% of respondents were aware about FOPL. Majority of the respondents rarely or never read nutrition labels (87%) or compared nutritional content of two similar items before purchasing (89%). Sixty-two per cent of respondents considered nutrition labelling as a guarantee of food safety. ‘Multiple Traffic Light’ was the most preferred FOPL design (43%), followed by ‘Health Star Rating’ (21%). Conclusion: There is low awareness of FOPL and a knowledge-behaviour gap amongst the residents. This gap needs to be addressed to ensure better patient counselling for healthy eating choices.

Exploring the perception of small and medium food enterprises in Lincolnshire, UK on the use of front‐of‐pack nutrition labels by consumers

SummaryThe food and drink industry is the UK's largest manufacturing sector, and small to medium‐sized enterprises (SMEs) play a key role in the UK's food system. This study investigates food‐providing SMEs' knowledge of nutrition labels and perceptions of the use of front‐of‐pack nutrition labels in making informed and healthy food choices by consumers. The SMEs were based in Lincolnshire, UK, and comprised food manufacturers (75%), food retailers (14%) and food service providers (11%) (n = 35). A 25‐item questionnaire was developed and validated to collect responses. The questionnaire link was disseminated by email and completed online. Comparisons were made between competing answers using Cochran's Q tests, each with post‐hoc pairwise McNemar test comparisons. Confidence intervals were computed using ordinal regressions. More than half of the SMEs' products (58%) had UK traffic light (TL) colour‐coded schemes and % Guideline Daily Amounts (GDAs). The SMEs stated that the TL label was the best format that provided ‘at‐a‐glance’ information, and this was significantly higher than %GDA and interpretative text (Ps &lt; 0.003). Nearly 49% of the SMEs were unaware of the front‐of‐pack labels being not mandatory in the United Kingdom. Many (86%) acknowledged that the nutrition information on food products was helpful or very helpful for consumers in making purchasing decisions. The SMEs seemed to place the costs of implementing FOP labels on food products above their helpfulness in making healthier food decisions by consumers. This research is one of the first to investigate the perceptions of SMEs on how consumers utilise nutrition labels when making healthier food choices in the United Kingdom. Government subsidies on the costs incurred by incorporating TL labelling on the products are necessary in order to have front of pack (FOP) labels mandatory in the United Kingdom. Greater food industry involvement in academic and policy‐related research is essential to creating a healthier and more sustainable food environment.

Sociodemographic differences in nutrition labels effect on Chilean and Mexican youth.

To examine sociodemographic differences in the awareness, understanding, use and effect of nutrition labels among Mexican and Chilean youth. Online surveys among youth (10-17 years) were obtained in 2019 (n=2631). Participants reported their awareness, understanding, and use of their country-specific nutrition facts tables (NFT) and front-of-pack labels (FOPL) (Chile: warning labels [WLs]; Mexico: guideline daily amounts [GDA]). Additionally, participants reported their perceived healthfulness of a sweetened fruit drink after viewing one of six versions of it with different FOPL (no-label control, Health Star Rating, WLs, GDAs, Traffic Light, or Nutri-Score) during an experimental task. Higher self-reported nutrition knowledge was associated with higher NFT and FOPL awareness, understanding, and use, except for WL use. WLs were the most effective FOPL in decreasing the perceived healthfulness of the sweetened fruit drink compared to a no-label condition and other FOP labels. In Chile, the effect of GDA differed by income adequacy, while in Mexico Nutri-Score differed by age. Results suggest that nutrition label awareness, use, understanding, and impact differ across demographics, favoring higher income and nutrition knowledge. Despite this, WLs are likely to have a positive impact on nutrition-related knowledge and behaviors among Mexican and Chilean youth, independently of their socio-demographic groups.