Preventing Chronic Disease | Evaluation of Consumer Understanding of Different Front-of-Package Nutrition Labels, 2010–2011 - CDC
Evaluation of Consumer Understanding of Different Front-of-Package Nutrition Labels, 2010–2011
Christina A. Roberto, PhD; Marie A. Bragg, MS, MPhil; Marissa J. Seamans, BA; Regine L. Mechulan, BA; Nicole Novak, MS; Kelly D. Brownell, PhD
Suggested citation for this article: Roberto CA, Bragg MA, Seamans MJ, Mechulan RL, Novak N, Brownell KD. Evaluation of Consumer Understanding of Different Front-of-Package Nutrition Labels, 2010–2011. Prev Chronic Dis 2012;9:120015. DOI: http://dx.doi.org/10.5888/pcd9.120015.
Governments throughout the world are using or considering various front-of-package (FOP) food labeling systems to provide nutrition information to consumers. Our web-based study tested consumer understanding of different FOP labeling systems.
Adult participants (N = 480) were randomized to 1 of 5 groups to evaluate FOP labels: 1) no label; 2) multiple traffic light (MTL); 3) MTL plus daily caloric requirement icon (MTL+caloric intake); 4) traffic light with specific nutrients to limit based on food category (TL+SNL); or 5) the Choices logo. Total percentage correct quiz scores were created reflecting participants’ ability to select the healthier of 2 foods and estimate amounts of saturated fat, sugar, and sodium in foods. Participants also rated products on taste, healthfulness, and how likely they were to purchase the product. Quiz scores and product perceptions were compared with 1-way analysis of variance followed by post-hoc Tukey tests.
The MTL+caloric intake group (mean [standard deviation], 73.3% [6.9%]) and Choices group (72.5% [13.2%]) significantly outperformed the no label group (67.8% [10.3%]) and the TL+SNL group (65.8% [7.3%]) in selecting the more healthful product on the healthier product quiz. The MTL and MTL+caloric intake groups achieved average scores of more than 90% on the saturated fat, sugar, and sodium quizzes, which were significantly better than the no label and Choices group average scores, which were between 34% and 47%.
An MTL+caloric intake label and the Choices symbol hold promise as FOP labeling systems and require further testing in different environments and population subgroups.
Different FOP symbols are in use outside the United States. Two prominent ones are the Traffic Light (TL) food labeling system developed by the United Kingdom’s Food Standards Agency (UK FSA) and the Choices symbol, adopted by countries such as the Netherlands and Poland (4,5). The TL system highlights amounts of total fat, saturated fat, sugar, and sodium in foods, and the Choices symbol appears on products that meet dietary guidelines developed by an international scientific committee (5).
The existence of various FOP labeling systems prompted the US Food and Drug Administration (FDA) to undertake an initiative (6) to evaluate these systems. As part of this initiative, the Institute of Medicine (IOM) prepared 2 reports that provide science-based recommendations for an optimum labeling system (7,8). However, few studies of FOP labeling systems in US populations have been conducted, making it difficult to draw conclusions about the best system. Our study was designed to determine which of several approaches to FOP labeling would be most likely to enable consumers to identify the healthiest food options within the same food category and would promote accurate understanding of the nutritional composition of packaged foods. We examined 4 labels in our study, including the Choices symbol and 3 different versions of the Multiple Traffic Light (MTL) system (4), a calories-per-serving label system that indicates whether a product contains high, medium, or low amounts of 3 nutrients that should be consumed in limited quantities: saturated fat, sodium, and sugar.