Nutrition Facts Table Research Articles

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.

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.

Understanding and use of food labeling systems among Whites and Latinos in the United States and among Mexicans: Results from the International Food Policy Study, 2017

BackgroundObesity and chronic diseases could be prevented through improved diet. Most governments require at least one type of food labeling system on packaged foods to communicate nutrition information and promote healthy eating. This study evaluated adult consumer understanding and use of nutrition labeling systems in the US and Mexico, the most obese countries in the world.MethodsAdults from online consumer panels in the US (Whites n = 2959; Latinos n = 667) and in Mexico (n = 3533) were shown five food labeling systems: 1. Nutrition Facts Table (NFT) that shows nutrients of concern per serving; 2. Guideline Daily Amounts (GDA) that shows levels of nutrients of concern; 3. Multiple Traffic-Light (MTL) that color codes each GDA nutrient (green = healthy; yellow = moderately unhealthy; red = unhealthy); 4. Health Star Rating System (HSR) that rates foods on a single dimension of healthiness; 5. Warning Label (WL) with a stop sign for nutrients present in unhealthy levels. Participants rated each label on understanding (“easy”/“very easy to understand” vs “difficult”/“very difficult to understand”), and, for NFTs and GDAs, frequency of use (“sometimes”/“often” vs “never”). Mixed logistic models regressed understanding and frequency of use on indicators of labeling systems (NFT = ref), testing for interactions by ethnicity (US Latinos, US Whites, Mexicans), while controlling for sociodemographic and obesity-related factors.ResultsCompared to the NFT, participants reported greater understanding of the WL (OR = 4.8; 95% CI = 4.4–5.3) and lower understanding of the HSR (OR = 0.34, 95% CI = 0.31–0.37) and the MTL (OR = 0.56, 95% CI = 0.52–0.61), with similar patterns across ethnic subgroups. Participants used GDAs less often than NFTs (OR = 0.48; 95%CI = 0.41–0.55), with the greatest difference among US Whites (OR = 0.10; 95%CI = 0.07–0.14).ConclusionsUnderstanding and use of the GDA was similar to that of the NFT. Whites, Latinos, and Mexicans consistently reported the best understanding for WLs, a FOPL that highlights unhealthfulness of a product. Therefore, a FOPL summary indicator, such as WLs, may be more effective in both the US and Mexico for guiding consumers towards informed food choices.

Changing Sodium Knowledge, Attitudes and Intended Behaviours Using Web-Based Dietary Assessment Tools: A Proof-Of-Concept Study.

Despite public health efforts to reduce dietary sodium, sodium intakes in most countries remains high. The purpose of this study was to determine if using novel web-based tools that provide tailored feedback, the Sodium Calculator and Sodium Calculator Plus, improves users’ sodium-related knowledge, attitudes, and intended behaviours (KAB). In this single arm pre- and post-test study, 199 healthy adults aged 18–34 years completed a validated questionnaire to assess changes to sodium-related KAB before and after using the calculators. After using the calculators, the proportion of participants who accurately identified the sodium adequate intake and chronic disease risk reduction level increased (19% to 74% and 23% to 74%, respectively, both p = 0.021). The proportion accurately self-assessing their sodium intake as ‘high’ also increased (41% to 66%, p = 0.021). Several intended behavioural changes were reported, i.e., buying foods with sodium-reduced labels, using the Nutrition Facts table, using spices and herbs instead of salt, and limiting eating out. Evidence-based eHealth tools that assess and provide personalized feedback on sodium intake have the potential to aid in facilitating sodium reduction in individuals. This study is an important first step in evaluating and optimizing the implementation of eHealth tools to help reduce Canadians’ sodium intakes.

Conceptions of Brazilian Elementary and High School Students about Food Nutrients

The study was undertaken to investigate the conceptions of Brazilian Basic Education (Elementary and High School) Students about food nutrients, food pyramids, processed food labels and nutrition facts tables. The research involved groups from sixth to ninth grades of Elementary School and first to third grades of High School in a public school from Paraná State, Brazil. In this study, 257 students, aged 11 - 17 years old, took part. For the identification of conceptions, group activities were performed using food pyramids, processed food labels and nutrition facts tables, aiming the analysis of their nutritional composition by students. Analysis showed students do not show satisfactory and coherent conceptions about food nutrients, and many students were not able to distinguish nutrients from food. In this sense, we highlight the need of Food Nutrition programs to endorse and include initiatives for students, regarding the positive comprehension of nutrients and their benefits to the body, besides healthy eating habits.

Consumer purchase intentions for pork with enhanced carnosine–A functional food

AbstractIn this study, Canadian consumers’ preferences for enhanced carnosine (a naturally occurring dipeptide that exhibits antiaging properties) in pork are examined. Carnosine is a relatively unknown nutrient to the public such that we are interested in understanding the relative merits of informing consumers of enhanced carnosine levels through a possible health claim, a nutrient content claim or including it in the nutrition facts table (NFT). As a basis of comparison, we include two other possible labels, a protein nutrient content claim, and a Verified Canadian Pork label (created by industry identifying food safety, animal care, traceability, and farm to table quality assurance attributes of the production system). Data were collected through an online survey that included a choice experiment and were analyzed using conditional logit and random parameters logit models. Compared to carnosine (as a functional attribute), consumers prefer the identification of protein content. In terms of labeling carnosine, consumers have higher willingness to pay for carnosine content included in a NFT than for nutrient or health claims. Higher levels of nutrition knowledge are associated with higher willingness to pay for the different pork attributes.

Innovative educational program based on banduras social cognitive theory for food label understanding in early adolescents

Adolescence offers an intervention opportunity to prevent the onset of health damaging behavior, and establish healthy eating habits. In the current scenario, when there are shifts from homemade to prepackaged foods, food labeling could serve as a population-based approach to help consumers make healthy choices. The food label is direct means of communication of product information between buyer and sellers. It enables the consumer to differentiate between foods and brands to make informed purchasing choices. Food labeling represents a valuable tool to help consumers make informed decisions about their diet, life-style and plays an important role by disseminating important nutrition information to consumers. The present study is a school based educational intervention study, designed to measure changes in nutrition related knowledge, understanding and use of nutrition facts on food label by obtaining pre and posttest intervention scores using questionnaire technique. The research work was conducted in four phases. Phase me with objective to assess eating habits, nutrition status of early adolescents and their existing nutrition knowledge, attitude, and understanding of food labels. Phase II to develop an educational program based on Banduras social cognitive theory. Phase III to impart education on food label through the developed educational program and Phase IV to assess the understanding of the adolescents regarding food label. The sample of the study was 490 early adolescent children from seven government schools of Delhi. The experimental group was of 250 and control group comprised of 240 students. The average pretest scores in experimental group for nutrition knowledge were 2.62 which significantly increased to 8.24, for attitude towards information on food label scores significantly increased from 20.41 to 29.92, scores of practice of using information on food label significantly increased from 20.63 to 28.24 and scores for understanding the nutrition facts on food label too significantly increased from 1.24 which to 3.75, whereas no significant improvement in scores were observed in control group. The results thus demonstrate that children participating in this study successfully learned how to read and compare information on food label. The research also, demonstrates that innovative teaching session, on food labels with emphasis on understanding the nutrition facts table can enable children to select foods which are healthy after carefully reading the food label.

Consumer responses to private nutrition signals

ABSTRACTMandatory labelling of nutrition information with a numerical nutrition facts panel is commonly required for prepackaged food products. Recently, food manufacturers and retailers have developed simplified nutrition signals such as front-of-package labelling (e.g. the Traffic Light label) or retail shelf labels (e.g. Guiding Stars), which provide a more intuitive signal of nutritional content. Using survey data from a sample of consumers from western Canada, this paper examines consumer responses to two private nutrition labelling programs: Guiding Stars and the Traffic Light label. Consumers are more receptive to the Traffic Light label than the Guiding Stars. Ordered probit models explore the factors influencing the likelihood of using these nutrition signals. Trust in the food label, perceived difficulty of using nutrition information, nutrition knowledge, and the importance placed on nutrition influence receptively to these labels. Simplified nutrition labels are likely to complement, rather than substitute for, the existing Nutrition Facts Table.

Size Matters: Package Size Influences Recognition of Serving Size Information

To identify the impact of package size on an individual's use of serving size information. The hypothesis was that participants would make more serving size assumption errors on a nutrition facts table (NFT) interpretation task when assessing packages that appear as a single serving but contain multiple servings, compared with products that appear as a multi-serving and contain multiple servings. Sixty participants were randomized into 1 of 3 conditions (n = 20 each); products that appeared as a single serving and contain a single serving (SSSS), products that appeared as a single serving and contain multiple servings (SSMS), and products that both appear as a multi-serving and contain multiple servings (MSMS). All 3 conditions were tested on a NFT interpretation task while participants were being presented food items that were appropriate to their given condition. Participants in the SSMS (9.55 ± 7.78) condition made significantly more serving size assumption errors than the SSSS (0.00 ± 0.00; P < 0.001) and MSMS (0.40 ± 0.75; P < 0.001) conditions. Participants did not address serving size information when they perceived a product to be a single serving. This resulted in people misinterpreting nutritional and caloric content of foods that were single unit foods with multiple servings.

Unregulated serving sizes on the Canadian nutrition facts table \u2013 an invitation for manufacturer manipulations

BackgroundServing sizes on the Nutrition Facts table (NFt) on Canadian packaged foods have traditionally been unregulated and non-standardized. The federal government recently passed legislation to regulate the serving sizes listed on the NFt. The objective of this study was to compare the serving sizes on food product NFts to the recommendations in the 2003 Nutrition Labelling regulation (Schedule M) reference amounts, the Canadian Food Inspection Agency (CFIA) ranges, and Canada’s Food Guide recommendations. An additional objective was to determine if food and beverage products that report smaller serving sizes have a higher calorie density, compared to similar products with a larger serving size.MethodsData for 10,487 products were retrieved from the 2010 Food Label Information Program (FLIP) database and categorized according to Schedule M categories. Correlations between calorie density and manufacturer stated serving size were tested and the proportion of products meeting recommendations were tabulated.Results35% of products had serving sizes on the NFt that were smaller than the Schedule M reference amount and 23% exceeded the reference amount. 86% of products fell within the CFIA’s recommended serving size ranges; however, 70% were within the lower-half of the range. Several bread and juice categories exceeded CFG’s recommendations, while several dairy product categories were smaller than the recommendations. Of the 50 Schedule M sub-categories analyzed, 31 (62%) exhibited a negative correlation between serving size and calorie density.ConclusionWhile most products fell within the CFIA’s recommended serving size ranges, there was a tendency for products with a higher calorie density to list smaller serving sizes.

Benchmarks and Blinders: How Canadian Women Utilize the Nutrition Facts Table.

To better understand how consumers use the Nutrition Facts Table (NFT) in their everyday shopping decisions and food consumption habits. Thirteen Canadian females were interviewed about how they use the NFT in their food choices. Different elements of the front of the package served different purposes. Health claims and health checks drew attention to the product, but were not highly trusted. Ingredient lists were used to find "real food." NFTs were considered important with each participant reporting an individualized strategy for using the NFT characterized by the application of benchmarks and blinders. The term "blinders" reflected only seeing and using one specific nutrient by assessing whether or not it exceeded a certain "benchmark" established by the participant. Therefore, the level of one specific nutrient determined the healthfulness of the product and the subsequent purchase/consumption decision. Findings suggest that NFTs should be redesigned. Some ideas for redesign include only listing "unhealthy" nutrients, having serving sizes more congruent to what is eaten in a typical sitting, making it easier to identify when a food may be high in a nutrient, and providing ways to allow the NFT to be used to meet personal, individualized needs.

Analysis of the presence of nutrient claims on labels of ultra-processed foods directed at children and of the perception of kids on such claims

ABSTRACT Objective: To characterize the presence of nutrient claims on the front-of-pack labels of ultra-processed foods directed at children and gain insight on children' views about the presence of marketing strategies and nutrient claims on labels of ultra-processed foods. Methods: Analysis of images (front panel, nutrition facts table, and ingredients list) of labels from 535 packaged foods with marketing strategies directed at children obtained in an audit-type survey conducted at a Brazilian large supermarket store. Food products with ultra-processed characteristics were identified, and the nutrient claims were quantified and described. Focus groups were conducted with children aged 8-10 years. Results: A total of 472 (88.0%) of the 535 packaged foods directed at children were classified as ultra-processed. Of these, 220 (46.6%) had one or more nutrient claims on their front-of-pack label (n=321), most (n=236, 73.5%) claiming the presence/increased quantities of vitamins and minerals. The most common 'free/reduced' content claim regarded trans fat content (n=48). The focus groups allowed the identification of a noticeable influence of nutrition claims on children, who considered the emphasis important but were confused by the meaning and focus of such claims. Conclusion: Highlighted nutrient claims on the packages of ultra-processed foods were common and seemed to influence the children's perception of the products' quality as a whole. The results indicate the need of thoroughly reviewing the legislation on nutrient claims on the packages of ultra-processed foods.

The efficacy of calorie labelling formats on pre-packaged foods: An experimental study among adolescents and young adults in Canada.

Several countries have proposed changes to calorie labelling on nutrition facts tables (NFTs) on pre-packaged foods. As most research to date has examined general use of NFTs, there is a lack of evidence to guide specific design changes to calorie information on labels. This study examined the efficacy of various calorie labelling formats on recall, comprehension, and consumer preferences for calorie information. Experiments were conducted as part of an online survey with a national sample of 2,008 Canadians aged 16-24. In Task 1, participants were shown one of six labelling formats (e.g., %DV, Traffic Light) with calories in either small or large font, and asked to recall the amount of calories. Task 2 examined comprehension of calories in the context of recommended daily intake (RDI), using the same NFT as in Task 1. Task 3 identified participants' preferences for labelling formats. NFTs with calories in large font enhanced calorie recall (p &lt; 0.001). When small font was displayed, the Traffic Light format performed best at improving recall (p &lt; 0.01). With large font, the highest recall was in the Current, RDI and Traffic Light formats (all p &lt; 0.05). Comprehension of servings per RDI was highest in the Infographic format, with no difference by font size (p &lt; 0.001). Respondents preferred the large font calorie condition and the Infographic format (p &lt; 0.001). Enhancements in visibility and design can improve the efficacy of calorie labelling on pre-packaged foods. The findings have direct implication for proposed changes to calorie labelling on NFTs in Canada and the United States.

Examination of food industry progress in reducing the sodium content of packaged foods in Canada: 2010 to 2013.

In 2010, as part of a national sodium reduction strategy, Canada published sodium reduction benchmark targets for packaged foods; however, no evaluation of this policy has occurred. The objective was to evaluate changes in the sodium content of packaged foods, identify categories reduced in sodium, and determine the proportion meeting Health Canada's sodium reduction benchmarks. This was a cross-sectional analysis of Canadian packaged foods in 2010 and 2013 (n = 10 487 and n = 15 394, respectively). Sodium content was obtained from the Nutrition Facts table. Overall, 16.2% of food categories had significantly reduced sodium levels. The greatest shifts in the distribution of sodium within food categories occurred in imitation seafood (mean ± SD, mg/100 g; 602 ± 50 to 444 ± 81, 26.2%, p = 0.002), condiments (1309 ± 790 to 1048 ± 620, 19.9%, p = 0.005), breakfast cereals (375 ± 26 to 301 ± 242, 19.7%, p = 0.001), canned vegetables/legumes (269 ± 156 to 217 ± 180, 19.3%, p < 0.001), plain chips (462 ± 196 to 376 ± 198, 18.6% p = 0.004), hot cereals (453 ± 141 to 385 ± 155, 15.0%, p = 0.011), meat analogues (612 ± 226 to 524 ± 177, 14.4%, p = 0.003), canned condensed soup (291 ± 62 to 250 ± 57, 14.1%, p = 0.003), and sausages and wieners (912 ± 219 to 814 ± 195, 10.7%, p = 0.012). The proportion of foods meeting at least 1 of the 3 phases of the sodium reduction benchmark targets slightly increased (51.4% to 58.2%) and the proportion exceeding maximum benchmark levels decreased (25.2% to 20.8%). These data provide a critical evaluation of changes in sodium levels in the Canadian food supply. Although progress in reducing sodium in packaged foods is evident, the food industry needs to continue efforts in reducing the sodium in the foods they produce.

Knowledge of Recommended Calorie Intake and Influence of Calories on Food Selection Among Canadians

ObjectiveTo examine knowledge of recommended daily calorie intake, use of calorie information, and sociodemographic correlates between knowledge and use. DesignPopulation-based, random digit–dialed phone surveys. ParticipantsCanadian adults (n = 1,543) surveyed between October and December, 2012. Main Outcome MeasuresKnowledge of recommended calorie intake and use of calorie information when purchasing food. AnalysisRegression models, adjusting for sociodemographics and diet-related measures. ResultsOverall, 24% of participants correctly stated their recommended daily calorie intake; the majority (63%) underestimated it, whereas few (4%) overestimated it. Females, younger participants, those with a higher income and more education, and those who consumed fruits and vegetables at least 5 times daily were significantly more likely to state recommended intake correctly. Most respondents (82%) reported considering calories when selecting foods. Respondents considered calories more often if they were female, had a higher income and more education, perceived themselves to be overweight, were actively trying to control their weight, reported a healthier diet, or consumed fruits and vegetables at least 5 times daily. Conclusions and ImplicationsAlthough most Canadians reported using calorie information to guide their food choices, few knew their daily recommended calorie intake. To promote healthy weights, policy initiatives, including education regarding daily calorie intake and changes to the Nutrition Facts table, may help consumers make better choices about food.

Comprehension and Use of Nutrition Facts Tables among Adolescents and Young Adults in Canada.

Limited evidence exists on the comprehension and use of Nutrition Facts tables (NFt) among adolescents and young adults. This study provides an account of how young people engage with, understand, and apply nutrition information on the current and modified versions of the NFt to compare and choose foods. Participants aged 16-24 years (n = 26) were asked to "think aloud" while viewing either the current or 1 of 5 modified NFts and completing a behavioural task. The task included a questionnaire with 9 functional items requiring participants to define, compare, interpret, and manipulate serving size and percentage daily value (%DV) information on NFts. Semi-structured interviews were conducted to further probe thought processes and difficulties experienced in completing the task. Equal serving sizes on NFts improved ability to accurately compare nutrition information between products. Most participants could define %DV and believed it can be used to compare foods, yet some confusion persisted when interpreting %DVs and manipulating serving-size information on NFts. Where serving sizes were unequal, mathematical errors were often responsible for incorrect responses. Results reinforce the need for equal serving sizes on NFts of similar products and highlight young Canadians' confusion when using nutrition information on NFts.

Accuracy of Canadian food labels for sodium content of food.

The accuracy of the Nutrition Facts table (NFt) has a significant impact on Canadian efforts to reduce dietary sodium and monitor sodium content in foods. This study assessed the accuracy of sodium (and calories, trans fat, saturated fat, sugar) reported on the NFt for selected foods and beverages in Canada. The Canadian Food Inspection Agency (CFIA) sampled over 1000 foods and beverages from supermarkets, bakeries, and restaurants across Canada between January 2006 and December 2010. The samples were analyzed in CFIA laboratories. Results were requested for products with ≥1 of the following nutrients tested: sodium, calories, saturated fat, trans fat, and sugar. Differences between the label and laboratory values were calculated for each product. Overall, 16.7% (n = 169) of products were “unsatisfactory” with laboratory values exceeding ±20% of the NFt value. Sodium had the highest number of unsatisfactory products (n = 49, 18.4%) and trans fat had the lowest number of unsatisfactory products (n = 16, 4.3%). The proportion of unsatisfactory products for saturated fat, calories, and sugar was 15.8%, 14.2%, and 12.9%, respectively. All of the unsatisfactory products had excess nutrient content relative to the NFt. Sodium and calories were consistently underreported (p < 0.05), while NFt values for the other nutrients were not statistically different than laboratory values. Increased monitoring of NFt sodium values is recommended in order to increase consumer confidence in this nutrition tool, to encourage industry to accurately report nutrient content and to continue using the NFt to guide research, education, and policy development.

Using verbal protocol to examine the comprehension and use of nutrition facts tables among young Canadians (390.8)

OBJECTIVES: To explore how young Canadians engage with, understand, and use serving size and %DV information on current and modified Nutrition Facts Tables (NFts).METHODS: 26 participants aged 16‐24 years were recruited. Participants were randomly assigned to two NFts, one with high (蠅15%DV) and one with low (≤5%DV) sodium amount, altered to one of the 6 conditions: 1) Current NFts; 2) Standardized serving sizes (SSS); 3) High/Low (H/L) descriptors beside % Daily Value (%DV) for negative nutrients; 4) SSS + H/L descriptors; 5) H/L and color beside %DV; and 6) SSS + H/L and color. Participants completed a skill‐based questionnaire using the “think aloud” technique. Content analysis was used to examine how participants interpret, define, compare, and manipulate information in NFts.RESULTS: Exploration of participants’ thought processes identified barriers to understanding and using the current NFt. The barriers include failure to understand %DV, difficulty in manipulating %DV to compare nutrients across various serving sizes, and confusion about how to use NFt to choose foods. Analysis also revealed that the barriers mentioned above can be addressed by standardizing serving sizes on NFts and adding simple descriptors and/or colors to %DV information.CONCLUSIONS: SSS and H/L descriptors or color coded %DV information assists young people in understanding and using NFts when comparing and choosing foods.

Consumer perceptions of the Nutrition Facts table and front-of-pack nutrition rating systems

Preferences for, and consumer friendliness of, front-of-pack (FOP) nutrition rating systems have not been studied in a Canadian population, and studies comparing systems that are accompanied by mandatory labelling, such as Canada's Nutrition Facts table (NFt), are lacking. The purpose of this study was to evaluate 4 FOP systems relative to the NFt with respect to consumer friendliness and their influence on perceptions of the healthiness and nutrient content of food. Canadian consumers (n = 3029) participating in an online survey were randomized to score the consumer friendliness of 1 of 5 FOP conditions with or without an NFt and to score the healthiness and nutrient content of 2 foods using the provided label(s). The mean differences in scores were evaluated with analysis of covariance (ANCOVA) controlling for age, gender, and education, with Tukey-Kramer adjustments for multiple comparisons. The NFt received the highest scores of consumer friendliness with respect to liking, helpfulness, credibility, and influence on purchase decisions (p < 0.05); however, consumers still supported the implementation of a single, standardized FOP system, with the nutrient-specific systems (a "Traffic Light" and a Nutrition Facts FOP system) being preferred and scored as more consumer friendly than the summary indicator systems. Without the NFt, consumer ratings of the healthiness and calorie and nutrient content differed by FOP system. With the NFt present, consumers rated the healthiness and calorie and nutrient content similarly, except for those who saw the Traffic Light; their ratings were influenced by the Traffic Light's colours. The introduction of a single, standard, nutrient-specific FOP system to supplement the mandatory NFt should be considered by Canadian policy makers.

Consumer Perceptions of Front-of-package Labelling Systems and Healthiness of Foods

The purpose of this study was to assess the impact of four different front-of-package (FOP) labelling systems on consumer perception and purchasing intent of food, and whether these systems help consumers select a balanced pattern of eating. The four FOP labelling systems studied included two nutrient-specific systems ‒ the Traffic Light (TL) and the Guideline Daily Amount (GDA) ‒ and two summary indicator systems ‒ NuVal(®) and My-5(®). Phase 1 was a small study with 36 participants to determine consumer understanding of the four FOP labelling systems and to inform the development of the questions for Phase 2, which consisted of a survey of 2,200 adults obtained through an online panel. Although the TL and GDA were rated similar to the Nutrition Facts table in terms of attributes, these FOP systems were considered more visually appealing. Consumers indicated that the numeric summary indicator systems did not provide sufficient information. Approximately half of the respondents indicated that the FOP systems would help them make healthier choices. However, due to the limitations of each, consumers often misinterpreted a food's healthiness compared to their baseline perceptions. Similarly, consumers' intent to purchase based on the FOP system did not show a consistent pattern. Although well received by consumers, FOP labelling systems can lead to confusion depending on perceived understanding of the system used. The nutrient-specific systems tend to be preferred by most consumers; however, the overall impact on selecting healthier eating patterns has yet to be demonstrated.