Nutrition Labels Research Articles

Nutritious Rice Consumption among Urban Consumers in Naypyitaw, Myanmar

Myanmar faces considerable nutrition challenges, including high rates of anemia, stunting, and wasting, alongside a growing prevalence of non-communicable diseases. Given the country’s high per capita rice consumption, nutritious rice offers a culturally compatible intervention to address these issues. This study investigates the factors associated with choices of nutritious rice among consumers in Naypyitaw, Myanmar. Data were collected from 481 participants and analyzed using a binomial logit model. Results indicate that only 17% of consumers have chosen nutritious rice in the past three years. Higher education levels, increased income, presence of health-vulnerable household members, and positive health behaviors—such as regular exercise, higher fruit intake, and attention to nutritional labeling—were found to significantly increase the likelihood of nutritious rice consumption. Conversely, perceived barriers related to availability and affordability significantly hinder consumption. Findings underscore the need for improvements in consumer knowledge and awareness of health benefits of nutritious rice, as well as policies supporting increased affordability and accessibility, to foster greater consumption and improve dietary health in Myanmar.

Visual nutrition analysis: leveraging segmentation and regression for food nutrient estimation

IntroductionNutrition is closely related to body health. A reasonable diet structure not only meets the body’s needs for various nutrients but also effectively prevents many chronic diseases. However, due to the general lack of systematic nutritional knowledge, people often find it difficult to accurately assess the nutritional content of food. In this context, image-based nutritional evaluation technology can provide significant assistance. Therefore, we are dedicated to directly predicting the nutritional content of dishes through images. Currently, most related research focuses on estimating the volume or area of food through image segmentation tasks and then calculating its nutritional content based on the food category. However, this method often lacks real nutritional content labels as a reference, making it difficult to ensure the accuracy of the predictions.MethodsTo address this issue, we combined segmentation and regression tasks and used the Nutrition5k dataset, which contains detailed nutritional content labels but no segmentation labels, for manual segmentation annotation. Based on these annotated data, we developed a nutritional content prediction model that performs segmentation first and regression afterward. Specifically, we first applied the UNet model to segment the food, then used a backbone network to extract features, and enhanced the feature expression capability through the Squeeze-and-Excitation structure. Finally, the extracted features were processed through several fully connected layers to obtain predictions for the weight, calories, fat, carbohydrates, and protein content.Results and discussionOur model achieved an outstanding average percentage mean absolute error (PMAE) of 17.06% for these components. All manually annotated segmentation labels can be found at https://doi.org/10.6084/m9.figshare.26252048.v1.

Compliance of Nutrient Claims with Nutrition Labelling Standards in Packaged Bakery Products

Aim: Nutrition claim means any representation which states, suggests or implies that a food has particular nutritional properties including but not limited to the energy value and to the content of protein, fat and carbohydrates, as well as the content of vitamins and minerals. Consumers may perceive foods carrying nutrition-related claims more positively because of the presence of a claim. However, sometimes the products may not be complaint with their nutrient claims. Place and Duration of Study: The study was carried out in Ludhiana, between 2021-2022. Methodology: In the present study, the packaged bakery products with nutrient claim (7 products) were selected from Ludhiana market and their complacency was evaluated in three phases- 1) Nutrient profiling through nutrition label on packaging 2) Nutrient content claims 3) Nutrient comparative claims. Results: The findings of the study revealed that the selected products such as Cornflake Biscuit, Max Protein cookies, Brownie, Sugar free cookies, Light biscuit, Whole wheat Biscuit and Brown bread were found with nutrient claims such as “rich in fiber”, “trans-fat free”, “cholesterol free”, “rich in protein”, “10g protein”, “4g fibre”, “contains calcium”, “no trans-fat”, “21g protein”, “rich in iron”, and “contains 6 vitamins”. In cornflake biscuits, data regarding nutrient comparative claims showed that the product without nutrition claim contained protein content (2.5g/100g) at par with the product with nutrition claim (2.3g/100g) while, dietary fiber content was significantly (p<0.05) lower in the former (0.98g/100g) as compared to later product (3.98g/100g). The laboratory analysis of max protein cookies showed that protein was present in cookies with a nutrition claim, indicating compliance of this product. However, the value (5.21g/100g) did not meet claim criteria value (10g/100g). Further, the product was compliant in term of claims related to fibre and calcium but the analyzed values such as 2.98g and 280mg per 100 g were found significantly lower (p<0.05) than the claim criterion. Most of the nutrient content claims related to protein and fibre did not meet information on the nutrition label, otherwise the selected products were compliant in terms of nutrition claims. Conclusion: In terms of nutrient content claims, the values of the nutrients obtained through laboratory analysis did not meet the claimed values on nutrition label. Therefore, further studies should focus on evaluating the prevalence and compliance of claims on foods with health or nutrition claim as consumers may perceive them as healthy.

Assessment of front and back of pack nutrition labels of selected convenience food products and snacks available in the Indian market.

Nutrition labels on packaged food items provide at-a-glance information about the nutritional composition of the food, serving as a quick guide for consumers to assess the quality of food products. The aim of the current study is to evaluate the nutritional information on the front and back of pack labels of selected packaged foods in the Indian market. A total of 432 food products in six categories (idli mix, breakfast cereals, porridge mix, soup mix, beverage mix and extruded snacks) were investigated by a survey. Nutritional profiling of the foods was done based on the Food Safety and Standards Authority of India (FSSAI) claims regulations. The healthiness of the packaged foods was assessed utilising nutritional traffic light system. The products were classified into 'healthy', 'moderately healthy' and 'less healthy' based on the fat, saturated fat, and sugar content. Most of the food products evaluated belong to healthy' and 'moderately healthy' categories except for products in extruded snacks. Reformulation of 'extruded snacks' are necessary to decrease the total and saturated fat content. The nutrient content claims were classified using the International Network for Food and Obesity / NCDs Research, Monitoring and Action Support (INFORMAS) taxonomy. Protein, dietary fibre, fat, sugar, vitamins and minerals were the most referred nutrients in the nutrient content claims. Breakfast cereal carried highest number of nutritional claims while porridge mix had the lowest number of claims. The overall compliance of the nutrient content claims for the studied food products is 80.5%. This study gives an overall view about the nutritional quality of the studied convenience food products and snacks in Indian market.

Hunger in America: Examining the Far–Reaching Effects of Food Insecurity in the United States of America

Food insecurity is a problem in the United States that cuts across all ethnic divides. The statistics related to Black people and children are astounding, as they represent highly vulnerable populations to the risk factors exacerbated by the inability to afford healthy meals. Since food insecurity impinges on people’s health, financial resources, and education, it should be curbed. Universal free meal programs at schools, promoting well-being policies with low healthcare costs, and educating people on nutrition labels, grocery lists, and budgeting must be practiced to fight against food insecurity effectively.

A well-visualized effect: How nutritional content–equivalent labels influence healthfulness perceptions

Consumers are increasingly relying on nutrition labels to assess the healthfulness of food products. Previous research has mainly explored abstract numerical labels that explicitly quantify nutritional content (e.g., “vitamin content: 268 mg”). However, given that consumers tend to process images more efficiently than numbers, this study investigates whether visualized nutritional content–equivalent labels (e.g., “vitamin content ≈▪[orange icons]”) convey nutrient content more effectively than numerical labels, thereby enhancing consumers’ healthfulness perceptions. The results indicate that visualized nutritional content–equivalent labels lead to higher perceived healthfulness compared to numerical labels, primarily due to the activation of mental imagery. However, this effect is attenuated when informational (vs. transformational) advertising appeals are used on the packaging. The findings emphasis the effectiveness of visualized nutritional content–equivalent labels in communicating healthy nutrition information to consumers.

Evidence-based food serving size labelling: Survey and laboratory analyses of consumer cooking spray usage.

Nutrition label serving sizes are determined primarily based on typical consumption when such data are available. However, such data are not available for certain foods such as spray cooking oil (cooking spray). Our study assessed cooking spray use by the United States (US) adults compared to the 0.25-s serving size used on US-sold cooking spray labels. Adults (n = 1041, aged 33 ± 16.7 years) completed a 13-question survey on cooking spray use and perceptions. In the survey, participants reported using cooking spray for 1.9 ± 0.9 s per use, and 42.3%-43.1% of participants reported being more likely to purchase products if they were labelled calorie- or fat-free. Next, 30 adults (aged 29.7 ± 11.0 years) completed a laboratory-based study which assessed cooking spray durations for seven cookware items. Spray times ranged from 1.0 ± 0.5 (smallest pan) to 2.5 ± 1.3 s (largest baking sheet), with 100% of sprays (210/210) exceeding the 0.25-s US serving size. Our results suggest that cooking spray serving size should be increased to 1 s to better reflect actual consumption, and this would have the added benefit of aligning better with cooking spray serving sizes in other developed countries (0.5-1.0 s). A 1-s serving size would also preclude cooking spray advertised as calorie- or fat-free, allowing consumers to make more informed choices on the dietary implications of using cooking spray.

Knowledge of nutritional labeling and labeling of packaged foods in school snacks in adolescents of an Educational Institution of Asuncion, Paraguay

Introducción: El etiquetado nutricional constituye una herramienta fundamental para la toma de decisiones alimentarias informadas. El objetivo fue evaluar el conocimiento sobre etiquetado nutricional y rotulado de alimentos envasados de la merienda escolar en adolescentes de 12 a 15 años de una institución educativa de Asunción durante 2023. Materiales y métodos: Estudio transversal descriptivo que incluyó 69 estudiantes (edad media 13±0,73 años). Se aplicó un cuestionario estructurado para evaluar conocimientos sobre etiquetado nutricional y rotulado de alimentos. Resultados: El 88,4% identificó correctamente la información calórica, mientras que solo 40,6% reconoció la información sobre fibra. El 81,2% identificó el rotulado de exceso de azúcares. El 66,7% adquiere sus meriendas en la cantina escolar, con predominio de consumo diario de jugos envasados (31,9%) y alimentos sin etiquetado nutricional (37,7%). Conclusión: Los adolescentes demuestran conocimiento del etiquetado nutricional, particularmente sobre calorías y azúcares, aunque este conocimiento no necesariamente influye en sus elecciones alimentarias.

Ability of a dietary index based on the updated algorithm underpinning the Nutri-Score to discriminate food consumption and nutrient intake in a French population of children and adolescents

IntroductionPreventing chronic diseases among children and adolescents requires a comprehensive approach. The Nutri-Score, a front-of-pack nutrition labeling system, may play an important role in public health by enhancing overall nutritional quality of dietary intake, a key modifiable risk factor. The aim of this study was to investigate the ability of the 2015 and 2023 NS-NPM to discriminate food consumption and nutrient intake in a population of French children and adolescents. MethodsChildren and adolescents (6 to 17 years old) participating in the cross-sectional representative ESTEBAN survey conducted in mainland France were included. Food consumption was assessed with three repeated 24 h dietary recalls. To obtain a dietary score at the individual level, the Nutri-Score nutrient profiling model dietary index (NS-NPM DI) was computed as an energy-weighted mean using the 2015 and the 2023 NS-NPMs and categorized into quartiles. Linear contrasts were used to assess the linearity of the association between the indexes and the intakes. Results1,279 participants (50.2 % boys and 49.8 % girls, mean age 11 years) were included in this study. Using the 2023 NS-NPM DI, participants with more favorable DI (lower NS-NPM DI) consumed higher amounts of fruits, vegetables, whole grain cereals, milk, poultry, fish and seafood and vegetable oils and lower amounts of, processed meat and sweetened foods. In addition, using the NS-NPM DI 2023, participants with more favorable DI (thus more favorable Nutri-Score) had higher intakes of proteins, fiber, vitamins and minerals, and lower intakes of lipids, SFA, MUFA and simple sugars. Compared to the NS-NPM DI 2015, with the updated algorithm, higher differences between quartiles were observed for tubers, fish and seafood, poultry, red meat, processed meat, vegetable oils and vitamin D and E, all in the expected direction (better discrimination). ConclusionThe results of the present study suggest that the NS-NPM algorithm underlying Nutri-Score is a useful tool for characterizing the diet quality of children and adolescents. The updated version of this algorithm showed a more discriminatory ability when assessing some animal food groups and vitamin D and E, indicating that the revision of the Nutri-Score represents an improvement for public health purposes.

Trends in food and nutrition behaviours, knowledge and attitudes among youth in six countries: findings from the 2019-2021 International Food Policy Study Youth Surveys.

This commentary highlights the release of findings now available in the report International Food Policy Study Youth Surveys: Summary of Findings 2019-2021. The survey data described in this commentary consist of repeated cross-sectional surveys conducted annually beginning in 2019. Online surveys were conducted in 2019 to 2021 among respondents living in Australia, Canada, Chile, Mexico, the United Kingdom and the USA. Survey respondents were youth aged 10-17 years in 2019 (n 12 031), 2020 (n 11 108) and 2021 (n 10 459). The report described in this commentary summarises findings on food and nutrition behaviours, attitudes and knowledge among youth, including their diet sources and patterns, school nutrition environments, food security, diet intentions, weight perceptions and weight loss behaviours, sugary drink perceptions, awareness of public education and mass media campaigns, perceptions of food labels and exposure to food and beverage marketing. Results from the IFPS Youth surveys provide important insights into key policies of global interest, including front-of-package nutrition labelling, levies on sugary beverages and restrictions on marketing unhealthy food and beverages to children. As policymakers continue to seek effective strategies to improve adolescent health outcomes, ongoing cross-country monitoring of food and nutrition-related indicators, such as the data from the International Food Policy Study, will be critical in assessing dietary trends and evaluating upcoming policies.

Food environments in the Pacific Region and efforts to improve them: A scoping review.

To understand the characteristics of food environments in the Pacific region, and the broader economic, policy, and sociocultural surroundings that influence food choices and interventions to improve food environments for Pacific communities. Systematic searches were conducted for articles related to food environments or factors influencing food choices from 1993-2024 in five academic databases, Google, Google Scholar, and relevant organizations' websites. Studies were included if they meet the eligibility criteria. Two authors independently reviewed the title and abstract of identified articles. Full-text screening was conducted before data was extracted from eligible studies. A narrative analysis was informed by an existing food environments framework. Pacific Island countries or territories that are a member of the Pacific Community (SPC). Not Applicable. From the 66 included studies (of 2520 records screened), it was clear that food environments in the Pacific region are characterized by high availability and promotion of ultra-processed unhealthy foods. These foods were reported to be cheaper than healthier alternatives and have poor nutritional labelling. Food trade and investment, together with sociocultural and political factors, were found to contribute to unhealthy food choices. Policy interventions have been implemented to address food environments; however, the development and implementation of food environment policies could be strengthened through stronger leadership, effective multisectoral collaboration and clear lines of responsibility. Interventions focused on improving physical, economic, policy, and sociocultural influences on food choices should be prioritized in the Pacific region to improve the food environment and mitigate barriers to healthy eating.

Contextual effects of color on food choices: Red ambient color induces indulgence

AbstractThis research examines how red ambient color in restaurants/cafeterias influences food choices. Prior research shows that red directly related to a food product (such as on nutrition labels or plates/cups) leads to avoidance of unhealthy foods. Yet, many successful fast‐food restaurants (e.g., McDonald's and Dairy Queen) use red in their ambiance, suggesting that in the context of food/eating, ambient red may have a different meaning than product‐related red. Indeed, the current research shows that consumers associate ambient red (e.g., wall color) with unhealthy restaurants. The presence of ambient red (vs. blue, gray, or white) leads to greater preference for unhealthy (i.e., high calorie, high fat, and indulgent) food options because consumers draw on ambient factors to make inferences about products sold in a retail establishment and then choose contextually appropriate products. The effect is moderated by the extent to which a consumer associates red with unhealthy restaurants. This research highlights how, in the context of food/eating, the placement of red influences its meaning and ultimately whether consumers approach or avoid unhealthy foods.

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

Nutrition 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. We 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. Globally, 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. Over 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.

Relative effect of warning labels on food choice: Case study with four product categories after the implementation of the Brazilian regulation

Warning labels have been implemented in different countries around the globe, including Brazil, to encourage healthier food choices. The aims of the present study were to evaluate the relative effect of different warning labels, brands and nutrition marketing claims on the food choice after the implementation of the Brazilian front-of package nutrition labelling regulation. Packages of four categories were designed considering the following factors: brand (familiar vs. unfamiliar), nutritional warning (present or absent), textual nutrition marketing claims (present or absent) and visual nutritional marketing claims (present or absent). A total of 850 Brazilian adults were recruited by a marketing agency. Participants were randomly allocated to one of two experimental conditions: black magnifier (n = 403) and black octagon (n = 447). They completed a choice task involving two out of four product categories: chocolate flavored milk, cookies, granola, and iced tea. The packaging was designed considering four factors: The presence of warning labels encouraged product choice in three of the four categories. However, brand and textual nutrition marketing claims had a larger effect. These results suggest the need to introduce comprehensive packaging regulations to reduce the prevalence of nutrition marketing claims on unhealthy products, as well as communication campaigns to raise awareness of the benefits of taking into account warning labels when making food purchases.

An exploration of progress made in the reformulation of food staples in the Republic of Ireland

One hundred and eleven countries currently have national policies, strategies or plans to implement food reformulation, a mechanism to passively improve the diets of consumers. Previous research by our group conducted between 2014 and 2017, showed that salt and sugar in - cereals, breads, spreads and milk had declined by 12% and 7%, respectively. The aim of this study was to explore if there has been further progress in reformulation during the period between 2017 and 2021.We conducted an audit of food staples in the Republic of Ireland. Nutrition labels of food staples were photographed and the extracted data was compared with data previously captured in 2017. We included Supermarkets with the leading market share in the Republic of Ireland at that time including - Dunnes Stores, Supervalu, Tesco, Aldi, Lidl, Marks & Spencer (M&S) and Centra. Two hundred and seventy products were directly compared across the two-time points (2017 & 2021). Overall across all food groups combined, this study shows that salt decreased by 1.9%, sugar levels decreased by 4.9% and saturated fat decreased by 0.1%. Total fat increased by 1.2%, protein increased by 1.1%, energy levels increased by 0.6%, fibre increased by 0.2% and carbohydrates increased by 0.1%. While it is encouraging to see that sugar has declined across all food groups and that salt has declined across most food groups in this study, the magnitude in reduction is lower than during the previous reporting period (2014–2017). Food manufacturers need to double down on their reformulation efforts.

Evaluating the prevalence of high fat sugar salt (HFSS) products and labelling characteristics of foods sold in-store Restricted Areas: A survey in three UK supermarkets following the 2022 implementation of The Food (Promotion and Placement) Regulations

Regulations restricting promotion of some High Fat, Sugar, Salt (HFSS) products within “restricted areas” (RAs) (e.g. end of aisles) of eligible supermarket stores came into force in October 2022 in England.To evaluate the prevalence of HFSS products, Front-of-Pack Nutrition Labelling (FOPNL) characteristics and categories of foods sold within RAs in a sample of supermarket stores, with respect to the Food (Promotion and Placement) Regulations 2021.A cross-sectional survey of products in RAs in three supermarkets.Following the manual identification of each supermarket’s RAs, from November 2022-January 2023, these were photographed and the display of products and their Front-of-Pack Nutrition Labelling (FOPNL) recorded. Products were identified using corresponding online supermarket webpages, from which data collected included product name, nutrition, and ingredients. This information was used to allocate each product to a category (e.g. ready meals) that was either in or out of scope of the Regulations. Evaluation of each product’s healthfulness was performed using the UK Nutrient Profiling Model (to determine HFSS status) and UK Multiple Traffic Light criteria to calculate number of inherent (i.e. possessed regardless of their display) Red Traffic Lights (iRTL). Prevalence of HFSS, FOPNL and iRTL were calculated as a proportion (%) of total products displayed in the included RAs. Associations between the prevalence of these characteristics were performed using chi-squared tests.Across the three stores, 86 RAs were identified, with data collected from 32 RAs displaying 679 food products, most of which fell into product categories considered out-of-scope of the Regulations (64%, n = 435). Across included RAs, the prevalence of HFSS products within all in and out-of-scope categories, was 42 % (n = 282). Half of all products (53%, n = 357) displayed FOPNL, and 16% possessed 1, 2 or 3 iRTL, including both HFSS and non-HFSS items. Across those product categories in-scope of the Regulations (n = 245), prevalence of HFSS was 17% (n = 42). These HFSS products were less likely to display FOPNL compared to non-HFSS products (2 = 25.01, p < 0.001).Following the implementation of The Food (Promotion and Placement) Regulations, intended to create healthier food retail environments, products sold across Restricted Areas of three eligible supermarkets included those in categories in and out of scope of Regulations with varied prevalence of less-healthy (HFSS) products, display of FOPNL, and possession of iRTL across both. This study is a first researcher-led evaluation of the recently regulated consumer-facing instore environment, with implications for future policy impact evaluation.

Nutrient profile models for front-of-pack nutrition labelling: a systematic review

BackgroundFront-of-pack nutrition labelling (FOPNL) is a key policy to tackle diet-related non-communicable diseases. All types of FOPNL require an underlying nutrient profile model (NPM). Nutrient profiling is a scientific method for classifying foods according to their nutritional composition. This review aimed to identify all NPMs developed and/or used for FOPNL, to assist with the selection of appropriate NPMs to underpin nutrition policies, namely supporting the WHO Regional Office for Europe developing template NPMs for FOPNL. MethodsWe searched peer-reviewed databases (MEDLINE, CAB Abstracts, OvidSP, and Scopus) and grey literature (Overton and Google). Searches were limited to articles published in English, Spanish or Portuguese, and published between Jan 1, 2016, and May 4, 2023, building on a comparable review conducted by Labonté et al. in 2016. To be eligible for inclusion, NPMs developed for FOPNL had to allow for the classification or ranking of individual foods, be developed or endorsed by governmental or inter- governmental organisations and have a publicly available algorithm. FindingsFrom the 957 publications retrieved in the searches, 39 NPMs were included: 13 for warning labels, 12 for nutrient-specific systems (including ‘traffic-light’ labelling), 10 for health endorsements and four for graded summary indicators. Of these, 26 NPMs have been developed and four models updated since 2016. The WHO Region with highest number of models was the Americas (n=13, 33%), followed by the European Region (n=9, 23%) and the Western-Pacific Region (n=7, 18%). InterpretationThere has been a proliferation of new NPMs for FOPNL posing a potential challenge for policymakers in the selection of appropriate models for FOPNL policies. This systematic review facilitates the comparison of these models, demonstrating considerable heterogeneity in the NPMs underlying FOPNL, indicating there is little consensus in what constitutes the most appropriate model and reinforcing the need for more guidance and regional alignment. FundingMSB's DPhil is supported by the Nuffield Department of Population Health and St Cross College Joint Scholarship, as well as by the Saven European Scholarship. JAR is funded by the ESRC (SALIENT: Food System Trials for Healthier People and Planet project, Award ID/ref: ES/Y00311X/1). AK is funded by the Nuffield Department of Primary Care Health Sciences, University of Oxford, the Wellcome Trust (SHIFT (Sustainable Healthy Interventions for Food Transition, Award ID: 227132/Z/23/Z), and the NIHR PHR (COPPER: CO-designing for healthy People and Planet: food Economic policy Research. Award ID: NIHR133887). MJR is funded by the Nuffield Department of Population Health, University of Oxford.

Comparison of front-of-package nutrition labelling schemes in Costa Rica: a multi-arm parallel-group randomised controlled trial assessing objective understanding and purchase intention

Different front-of-package labelling (FOPL) schemes have been developed worldwide to encourage informed and healthier food purchase decisions. However, few studies have formally compared different schemes, particularly in the Latin American context. This study aimed to assess the effects of four different FOPL schemes on the objective understanding of the nutritional content and intention to purchase products. This single-blinded multi-arm randomised controlled trial was conducted using a face-to-face survey with adult shoppers, recruited at supermarkets in Costa Rica (n=1350). Participants randomly assigned to intervention groups saw 12 mock-up products presented at random and balanced orders featuring one FOPL scheme or none: black octagonal warning labels (OWL), Nutri-Score (NUS), traffic-light labelling (TFL), guideline daily amounts (GDA), or no FOPL scheme (control group). Similar number of participants were analysed in each group: OWL (n=264), NUS (n=279), TFL (n=263), GDA (n=273), and control (n=271). Compared to the control group, the odds for correctly identifying the least harmful option more often were three times higher in the OWL group (OR 3.08; 95% CI, 2.26-4.20), and 89%, 57% and 19% higher in the TFL (1.89; 95% CI, 1.40-2.56), the GDA (1.57; 95% CI, 1.16-2.21) and the NUS (1.19; 95% CI 0.89-1.60), respectively. OWL also was more efficacious in helping participants to correctly identify a product with excessive amounts of sugars, sodium, and/or saturated fats, as well as in encouraging the intention to purchase the least harmful or the intention to choose none of the options in the choice task. OWL performed best in helping shoppers to correctly identify when a product contained excessive amounts of nutrients to limit, to correctly identify the least harmful option, and to intend to purchase the least harmful option, more often.

Knowledge, practices and perceptions of energy labelling of nut products among Australian consumers and stakeholders: an online survey.

Nut consumption in Australia is low, perhaps due to concerns with weight gain. However, nut consumption is not associated with increased weight, in part because of their lower metabolisable energy. Current energy labelling for nuts use Atwater factors, which over-represent the available energy from nuts. Therefore, this research aimed to examine stakeholders' knowledge, practices and perceptions of displaying true metabolisable energy on nutrition labels and its perceived impact on nut consumption. An anonymous and voluntary survey was conducted online. Eligible respondents lived in Australia, were aged 18 years or older and had either no formal nutrition education (consumer group) or had formal training and were working as a stakeholder (stakeholder group; working in nutrition/dietetics, public health, food industry, food regulation or nut growing). Convenience sampling and snowballing were used to recruit respondents primarily via online advertisement. Three hundred and forty-eight respondents (63.2% female; 71.0% aged 18-39 years; 69.0% Bachelor's degree or higher) were included in the analyses. A larger proportion of stakeholders agreed that nut consumption assists with weight management (67.9%) compared with consumers (47.6%). Theoretical food packaging showing both Atwater and metabolisable energy in the nutrition information panel was favoured among consumers and stakeholders, though 62.3% of consumers reported that a lower metabolisable energy of nuts would not impact their consumption. This study indicates a need to further investigate the impact of metabolisable energy labelling on nut intake. Further education about the relationship between nuts and body weight is required for consumers and stakeholders.

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.