Nutrition Labels Research Articles

The Role of Food Labels in Consumer’s Food Choices

One of the most important pillars of a healthy lifestyle is healthy nutritional value, in which FOP nutrition labels can support consumers in making the right decision. Nutrition-related diseases of civilization are a worldwide problem. A healthy diet is essential for overall well-being and the prevention of many chronic diseases. Special attention must be paid to the use of FOP nutrition values in order to prevention and healthy decision-making. It is important that people can interpret the nutritional quality of foods as simply as possible. The packaging has to provide realistic and accurate infromation about the product. This study describes four types of FOP nutrition labels used in the European Union: Nordic Keyhole, Nutri-Score, Traffic-Lights, NutrInform Battery. JEL-Code: M31

Association between nutritional literacy and nutrition label use in Chinese community residents.

Nutritional literacy (NL) has a critical influence on food choices. The objective of the present study was to examine the association of NL with nutrition label use. A cross-sectional study was conducted in Bengbu, China. In total, 955 adults were interviewed using a questionnaire designed for the present study to collect information on demographics, lifestyle, nutrition label use, and NL. Binary logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for nutrition label use and its predictive variables. In total, 40.4% of the participants reported looking at nutrition label when purchasing prepackaged foods. NL was significantly positively associated with nutrition label use and specifically with checking nutrition facts table, purported nutrition benefits and purported health benefits. In terms of specific facets of NL, nutrition knowledge, applying skills, and critical skills were associated with nutrition label use. After stratification by monthly income and education, the association between NL and nutrition label use was discovered only in individuals with low monthly income. Additionally, nutrition knowledge was associated with nutrition label use only in adults with high education level, whereas applying skills were associated with nutrition label use only in those with low education level. The use of nutrition label remains low among Chinese community residents, especially the purported nutritional benefits and purported health benefits. NL is positively associated with nutrition label use, especially with respect to functional and critical NL, with differences based on socioeconomic status. The findings highlight the need for NL interventions targeting individuals with different levels of education and income to encourage use of nutrition label in China.

Front-of-Pack Nutrition Labels

Front-of-pack nutrition labels that reflect and convey a food's nutritional value have a dual purpose. The first one is to promote consumer demand for more nutrient-rich foods. The second one is to motivate manufacturers to improve the quality of product portfolios by removing excess calories, fat, sugar, and salt. Whether front-of-pack nutrition labels can help shape food supply or food demand is a complex question that needs to be evaluated more closely.

Trends (2014-2018) in the healthiness of packaged food purchases of Australian consumers before and after the introduction of voluntary Health Star Rating nutrition labels.

To evaluate the trends in the healthiness of packaged food purchases of Australian consumers before and after the introduction of the Health Star Rating (HSR) nutrition labels. Panel data analysis and difference-in-differences analysis. The Australian Government endorsed HSR nutrition labels for voluntary implementation on packaged foods in June 2014. We analyse the packaged food purchases of households across all major supermarkets before (January 2014 to June 2014) and after (June 2014-Dec 2018) the introduction of HSR. 6284 members of a panel of households across Australia reporting their grocery purchases to a market research company (Nielsen Homescan panel). The healthiness of household food purchases exhibited a U-shaped trend - decreasing from 2014 to 2017, and then increasing from 2018, corresponding to the time when a higher proportion of products were HSR-labelled. Households that purchased a higher proportion of HSR-labelled products had healthier household purchases overall. Further, the healthiness of households' category-specific food purchases was positively associated with the proportion of HSR-labelled products in categories where HSR was adopted, relative to control categories where HSR was not adopted. In Australia, once a substantial number of packaged food products adopted the voluntary HSR summary indicator, we observed an increasing trend in the healthiness of household food purchases. Widespread adoption of a nutrition summary indicator, such as HSR, on packaged food is likely to be beneficial for population health.

Consideration of nutrition and sustainability in public definitions of 'healthy' food: an analysis of submissions to the US FDA.

To better understand how the public defines 'healthy' foods and to determine whether the public considers sustainability, implicitly and explicitly, in the context of healthy eating. We conducted a content analysis of public comments submitted to the US FDA in 2016 and 2017 in response to an invitation for feedback on use of the term 'healthy' on food labels. The analysis explored the ways in which commenters' definitions of 'healthy' aligned with the 2015-2020 Dietary Guidelines for Americans and whether their definitions considered sustainability. The US Government's Regulations.gov website. All 1125 unique comments from individuals and organisations. Commenters' definitions of 'healthy' generally mirrored the recommendations that the Dietary Guidelines for Americans put forth to promote a 'healthy eating pattern'. Commenters emphasised the healthfulness of fruit, vegetables, whole grains, fish and other minimally processed foods and the need to limit added sugars, sodium, saturated and trans fats and other ingredients sometimes added during processing. One-third of comments (n 374) incorporated at least one dimension of sustainability, mainly the environmental dimension. Commenters who mentioned environmental considerations primarily expressed concerns about synthetic chemicals and genetic modification. Less than 20 % of comments discussed social or economic dimensions of sustainability, and less than 3 % of comments (n 30) used the word 'sustainability' explicitly. This novel analysis provides new information about the public's perceptions of 'healthy' foods relative to nutrition and sustainability considerations. The findings can be used to advance policy discussions regarding nutrition labelling and guidance.

Food-related media use and eating behavior in different food-related lifestyle groups of Korean adolescents in metropolitan areas.

This study investigated the relationship between adolescent food-related lifestyles and food-related media use and eating behavior in Korea. Participants were 392 Korean adolescents, ranging in age from 12 to 18, recruited via convenience sampling. They completed a self-report questionnaire survey consisting of questions about food-related lifestyle, food-related media use, food consumption behavior, food literacy, and nutrition quotient. Data analysis was conducted using SPSS 29.0. (IBM Co., Armonk, NY, USA). The factor analysis of food-related lifestyles identified four factors. Based on the cluster analysis results, participants were classified into three clusters reflecting different levels of interest: high interest in food, moderate interest in food, and low interest in food. The analysis revealed significant differences between groups in food-related liestyle factors (P < 0.05). Notably, the high-interest group demonstrated proactive engagement with food-related content, a willingness to explore diverse culinary experiences, and a conscientious consideration of nutritional labeling during food purchases. In contrast, the low-interest group reported tendencies toward overeating or succumbing to stimulating food consumption post-exposure to food-related content, coupled with a disregard for nutritional labeling when making food choices. A stronger inclination toward a food-related lifestyle was positively correlated with higher levels of food literacy and nutrition quotient. This study proposes that the implementation of a nutrition education program using media could effectively promote a healthy diet among adolescents with a high level of interest in their dietary habits. For adolescents with low interest in their dietary habits, it suggests that introducing an education program with a primary focus on enhancing food literacy could be beneficial in fostering a healthy diet. Our research findings provide insight for the development of tailored nutritional education programs and establishment of effective nutrition policies.

Complementarity between the updated version of the front-of-pack nutrition label Nutri-Score and the food-processing NOVA classification.

To compare the initial and the updated versions of the front-of-pack label Nutri-Score (related to the nutritional content) with the NOVA classification (related to the degree of food processing) at the food level. Using the OpenFoodFacts database - 129,950 food products - we assessed the complementarity between the Nutri-Score (initial and updated) with the NOVA classification through a correspondence analysis. Contingency tables between the two classification systems were used. The food offer in France. Not applicable. With both versions (i.e. initial and updated) of the Nutri-Score, the majority of ultra-processed products received medium to poor Nutri-Score ratings (between 77·9 % and 87·5 % of ultra-processed products depending on the version of the algorithm). Overall, the update of the Nutri-Score algorithm led to a reduction in the number of products rated A and B and an increase in the number of products rated D or E for all NOVA categories, with unprocessed foods being the least impacted (-3·8 percentage points (-5·2 %) rated A or B and +1·3 percentage points (+12·9 %) rated D or E) and ultra-processed foods the most impacted (-9·8 percentage points (-43·4 %) rated A or B and +7·8 percentage points (+14·1 %) rated D or E). Among ultra-processed foods rated favourably with the initial Nutri-Score, artificially sweetened beverages, sweetened plant-based drinks and bread products were the most penalised categories by the revision of Nutri-Score while low-sugar flavoured waters, fruit and legume preparations were the least affected. These results indicate that the update of the Nutri-Score reinforces its coherence with the NOVA classification, even though both systems measure two distinct health dimensions at the food level.

Examining Nutrition Label Knowledge, Self-Efficacy, and Nutrition Facts Panel Usage

Examining Nutrition Label Knowledge, Self-Efficacy, and Nutrition Facts Panel Usage

Nutrition Labels of Foods: Friends or Foes in Public Health? Misleading Mistakes of U.S. FDA Nutrition Facts Label and Invention of a Reliable Nutrition Facts Label

Nutrition Labels of Foods: Friends or Foes in Public Health? Misleading Mistakes of U.S. FDA Nutrition Facts Label and Invention of a Reliable Nutrition Facts Label

Using co-design to identify intervention components to address unhealthy dietary and activity behaviours in New Zealand South Asians.

There is an urgent need to develop sustainable and impactful interventions to mitigate the high risk of diet-related non-communicable diseases (diet-NCDs) in South Asians living in high-income countries. The current study using a co-design methodology aimed to identify community-led intervention components (solutions) to address barriers and enablers of disease-promoting dietary and physical activity behaviours in New Zealand South Asians. Data were collected from South Asian immigrants aged 25-59 years via three focus group discussions (n = 21) and 10 telephone or face-to-face interviews between 2018 and 2019. The thematic analysis resulted in identifying 22 barrier and enabler codes and 12 solution codes which were summarised under five themes. The key solutions (intervention components) to mitigate the identified target behaviours were providing recipes for using local vegetables in South Asian cuisine, information on the nutritional quality of frozen vegetables and canned lentils, simple home gardening techniques, the saturated fat content of dairy foods, interpreting nutrition labels, optimal portion sizes of foods, and framing low-fat messages positively. Similarly, group-based activities with peer support such as walking, cultural dancing and community sports like cricket, football, and tennis were the identified solutions to increase physical activity levels. The identified solutions for health promoting dietary habits and physical activity levels could be part of any targeted multicomponent health promoting programme to reduce the risk of diet-NCDs in South Asian immigrants.

Patient and Community Health Worker (CHW) Perspectives on a CHW-delivered Nutrition Intervention for Low-Income Adults with Hypertension: A Qualitative Study.

Adults with food insecurity (FI) face barriers to hypertension management, including difficulty adhering to diet recommendations. Few community health worker (CHW) interventions focus on diet to improve blood pressure. This qualitative study elicited patient and CHW perspectives on healthy eating and a future CHW nutrition intervention for patients with hypertension. Twenty-five patients with hypertension and FI and 5 CHWs participating in a hypertension health coaching program from 5 Boston-area health centers participated in semi-structured interviews from July to September 2023. Interviews were audio recorded, transcribed, and analyzed using the Framework Method. Themes included: 1) Variable patient knowledge about dietary patterns for hypertension management and low confidence in interpreting nutrition labels; 2) Culture influenced healthy food perception; and 3) Barriers to healthy eating included cost, limited cooking abilities/supplies, and competing demands. Patients and CHWs favored simple nutrition education materials (e.g., traffic light nutrition ranking, healthy meals on a budget). Patients had mixed opinions about CHW-accompanied supermarket visits. This study identified culture, knowledge gaps, and budget constraints as factors influencing diet among patients with hypertension and FI. A CHW-delivered intervention could include simplified nutrition education, strategies for healthy eating on a budget, and linkage to community-based food programs.

The Role of Food Labels in Consumer’s Food Choices

One of the most important pillars of a healthy lifestyle is healthy nutritional value, in which FOP nutrition labels can support consumers in making the right decision. Nutrition-related diseases of civilization are a worldwide problem. A healthy diet is essential for overall well-being and the prevention of many chronic diseases. Special attention must be paid to the use of FOP nutrition values in order to prevention and healthy decision-making. It is important that people can interpret the nutritional quality of foods as simply as possible. The packaging has to provide realistic and accurate infromation about the product. This study describes four types of FOP nutrition labels used in the European Union: Nordic Keyhole, Nutri-Score, Traffic-Lights, NutrInform Battery. JEL-Code: M31

Parents knowledge of nutritional labeling and its impact on food choices

The nutritional label is a tool that helps parents to make decisions about their eating plan, in order to make safe purchases. The objective was to analyze the knowledge that parents have about nutritional labeling and its impact on food choices, for which an observational, prospective and analytical study was used. A questionnaire made up of 14 questions was applied to 36 settlers from a community in the State of Zacatecas. As a result, it was obtained that 97% do know the nutritional information table, and of these 69% if it seems important to read and understand the label, which influences when making the choice of food purchases, more than half of the population considers that the current design greatly favors reading. It was concluded that although the majority of the population already knows it, it is of vital importance that the totality of this, in addition to knowing it, fully understand it and take into account all the nutrients or substances that may harm it and thus be able to choose the best products for their diet and that of the family and thus have a better nutritional status.

Dietary indices underpinning front-of-pack nutrition labels and health outcomes: a systematic review and meta-analysis of prospective cohort studies

BackgroundNutrient profiling systems are increasingly used to characterize the healthfulness of foods for front-of-package (FOP) labeling, which have been proposed as an effective public health strategy to help people make healthier food choices. ObjectiveThis study aimed to review available evidence from cohort studies that evaluated the association of dietary indices underpinning FOP nutrition labels with all-cause mortality and incidence of cardiovascular diseases (CVDs) or cancer. MethodsPubMed, Web of Science, and Scopus were systematically searched up to October 2023. We included articles if they were prospective cohort studies, if the exposure was any dietary index underpinning FOP nutrition labels [e.g., the modified Food Standard Agency-Nutrient Profiling System (FSAm-NPS) and the Health Star Rating System], and if outcomes were all-cause mortality or incidence of or mortality due to CVD and cancer. Random-effects models were used to calculate the pooled hazard ratios (HRs) and 95% CIs. ResultsWe identified 11 records (7 unique prospective studies), which were included in the systematic review. The meta-analysis comprised 8 studies analyzing the FSAm-NPS dietary index (DI) as exposure. The pooled HRs associated with a 2-unit increase in the FSAm-NPS DI of all-cause mortality, CVD, and cancer risk were 1.06 (95% confidence interval [CI]: 0.99, 1.13; I2: 80%), 1.08 (95% CI: 1.00, 1.18; I2: 70%), and 1.09 (95% CI: 1.00, 1.19; I2: 77%), respectively. The Chilean Warning Label score and the Health Star Rating systems were examined by 1 study each and were significantly associated with the outcomes. ConclusionsDIs underpinning most common FOP nutrition labels and reflecting nutrient-poor diets show a tendency toward an increased incidence of CVD and cancer, but the observed effects are quite modest in magnitude. Further studies at the population level are needed to support the widely shared hypothesis that FOP labels, possibly in conjunction with other interventions, may contribute to reduce noncommunicable disease risk.This meta-analysis was registered at PROSPERO as CRD42021292625

Utilization of Nutrition Labels and Its Relation to Nutrient Intake among Cancer Survivors: The 2019–2021 Korea National Health and Nutrition Examination Survey

Utilization of Nutrition Labels and Its Relation to Nutrient Intake among Cancer Survivors: The 2019–2021 Korea National Health and Nutrition Examination Survey

Labeling of pickled vegetable products produced by agroindustries: compliance analysis based on the Brazilian legislation

Labeling is an important tool used to provide consumers with information about food products in compliance with health regulations. The aim of this study was to investigate the compliance of labels associated with pickled vegetable products produced by rural family agroindustries in the Serrana Region, Espírito Santo State, Brazil, with the Brazilian sanitary surveillance legislation. Secondary data from the State Food Monitoring Program developed by Espírito Santo State’s sanitary surveillance agency were herein used. Collected data were systematized into a legislation-based checklist comprising 108 items that were divided into 8 blocks, namely, General principles, Language, Mandatory information, Mandatory information presentation and distribution, Voluntary labeling, Gluten, Allergens, and Nutritional labeling of packaged foods. The results were analyzed through descriptive statistics, multivariate data analysis based on the Ward method, and non-hierarchical data analysis based on the K-means method. The minimum and maximum adequacy rates reached 23.1% and 94.3%, respectively, and the mean adequacy rate was 57.1%. The highest non-compliance mean values were linked to nutritional labeling (66.4%), gluten-incidence indication (55.2%), voluntary labeling (56.0%), and mandatory information presentation and distribution (42.8%). All product labels were classified as non-compliant; therefore, the health legislation was not met.

The impact of nutritional labeling on adult snack choices: A controlled field experiment in a non-commercial professional setting

Each year, 2.8 million people die because of comorbidities associated with being overweight. Snacking substantially contributes to people’s calorie intake. One way to nudge consumers towards healthier alternatives is the implementation of nutritional labeling. This study reports on a controlled field experiment that evaluates the effect of two nutritional labels on free snack choices (n = 739). Participants at a conference could choose between nuts, cookies, and candy bars as a snack, presented at the bar at six different locations across 2 bar counters. The labels were set up in front of each snack in three conditions: no labeling (control), a calorie label, or a traffic light label (i.e., the Nutri-Score). The location of the snacks on the counter (Either side of the counter; Center, Right, Left) and the time-of-day (Morning (=reference) vs Afternoon) were statistically controlled for. The results show that calorie labels could not successfully nudge consumers toward healthier snack choices (nuts instead of candy bars or cookies). In contrast, the Nutri-Score label significantly increased the probability of choosing nuts over candy bars. The Nutri-Score also increased the chance of choosing nuts over cookies, but the difference was not significant.No prior studies to our knowledge have directly compared calorie labels to the Nutri-Score. This study suggests that the Nutri-Score label can be a more successful intervention than calorie labels to nudge consumers towards healthier choices in situations were free snacks are offered, like many modern workplaces. Changing snacking behavior is challenging and naturalistic field experiments like this one are needed to translate the theory from previous laboratory studies to real-life settings.

Impact of food swap recommendations on dietary choices in an online supermarket: A randomized controlled trial

One novel strategy to shift food choices in digital shopping environments is to automatically recommend healthier alternatives when an unhealthy choice is made. However, this raises the question which alternative products to recommend. This study assesses 1) whether healthier food swap recommendations are effective, even though the unhealthy choice was made in the presence of visible FOP nutrition labels, and 2) how the similarity of the alternatives influences the acceptance of food swap recommendations. Based on a pre-test, similarity of the recommendation was operationalized in terms of animal-based versus plant-based options. A randomized controlled trial (healthy food swap recommendation conditions: none, similar animal-based, dissimilar plant-based, or mixed animal- and plant-based) with 428 Dutch participants was conducted in a simulated online supermarket. Additional healthier food swap recommendations improved the nutritional quality of the final basket compared to only providing Nutri-Score nutrition labels (−1.7 mean FSA score, p < .001, medium Cohen’s d = −0.48). Compared to the dissimilar condition, acceptance of an alternative was more likely in the mixed (odds-ratio = 2.78, p = .015) and in the similar condition (odds-ratio = 2.24, p = .048), but the nutritional quality of the final basket did not differ between treatment conditions. Individuals in treatment conditions who did not receive any recommendation (i.e. only made healthy choices) had higher Nutri-Score familiarity and general health interest than individuals who received recommendations. This suggests that for individuals with higher knowledge and motivation FOP nutrition labels were sufficient, whereas for individuals with lower knowledge and motivation additional food swap recommendations can improve dietary choices. Food swap recommendations may act as meaningful reminders by disrupting the automatic choice process and triggering individuals to rethink their (unhealthy) choice.

Sugar content in yogurts: What information is provided to consumers on the label?

This study focused on the observational and descriptive analysis of yogurt products available in major supermarket chains across Uruguay. A database of 120 yogurts was established using the FLIP-LAC program, facilitating the collection, storage, and analysis of packaging information. The findings revealed a diverse range of yogurts based on fat content, with 18% being whole, 49% low-fat, and 33% non-fat. Significantly, 97% of the yogurts contained sugar or alternative sweeteners, aligning with global trends and highlighting the prevalent use of sweetening agents in dairy products. The study underscored the challenges in assessing sugar intake due to the non-mandatory declaration of sugar content in nutritional labeling. Notably, 3% of yogurts did not contain any sweeteners or sugar. Additionally, 10% of the yogurts displayed an excess sugar warning octagon, indicating sugar content exceeding 26 g per serving. The study emphasized the need for enhanced nutritional education and public policies to empower consumers in making informed dietary choices. Despite regulatory efforts, the absence of mandatory sugar declarations on nutritional labels hinders consumers from tracking and managing their sugar intake effectively. The dataset revealed significant differences in sugar content-based categories on fat content, highlighting potential avenues for industry improvement in producing healthier yogurt options.

Restaurants' compliance with calorie labeling policies in food delivery applications.

To encourage consumers to make healthier choices, the Saudi Food and Drug Authority (SFDA) released the Saudi Arabia Nutrition Labeling Policy, which requires restaurants to present caloric information clearly on their menus. Food delivery applications are also mandated to present caloric information on their platforms. The aim of this study is to explore how restaurants on food delivery applications comply with the calorie labeling policy. Data were extracted from a widely used food delivery application in Saudi Arabia to include a sample of 120 "healthy food" restaurants. The restaurants were checked for compliance on both the application and the website. Descriptive and logistic regression analyses were performed to examine the distribution and association of relevant factors. A substantial proportion (43.3%) of healthy foods on delivery applications (n = 120) do not comply with the SFDA calorie labeling policies. Among these restaurants, 56.5% presented the calorie labeling on their menu item. Of those who provided calorie information on their websites (n = 62), 54.8% provided appropriate calorie labeling based on the SFDA policy. There was an association between compliance and the number of restaurant categories but no associations for website calorie labeling, rating, and appropriateness. This study provides important findings for policymakers that will enable them to reinforce food calorie policies on food delivery platforms, restaurant websites, social media, and marketing campaigns. Not all restaurants comply with the SFDA calorie labeling policies. Suggestions to present the calorie-related words in Arabic and offer more information to help the consumer make the appropriate food selection decision. Further studies are needed to explore the reasons for and barriers to posting nutritional information on menu items.