Overall, the computerized Canadian NVS performed as well as the interviewer-administered version for assessing health literacy levels of English- and French-speaking participants. This Canadian adaptation of the NVS provides Canadian researchers and public health practitioners with an easily administered health literacy assessment tool that can be used to address the needs of Canadians across health literacy levels and ultimately improve health outcomes.

An increasingly important concern in public health practice is health literacy. Simply stated, it refers to the interactions between individuals and health related information to make informed decisions concerning their health. Research shows that consumers face many health literacy challenges in accessing, understanding and evaluating nutrition labelling information when making food choices. The systematic integration of health literacy considerations into social science and consumer behaviour research can help address these challenges and better meet the needs of the increasingly diverse Canadian population. This application of a health literacy lens should be considered for all future food and nutrition labelling research, to maximize the positive impact of subsequent health policies and regulations on health outcomes and health status of Canadians.

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I like the logo "S" for "supplemented" on the front-of-pack. Whatever is on the back, this sets it up, that it is supplemented. So if there is a public education campaign on recognizing that logo, that would be a good start." •Understanding of Supplemented Foods -"If I wanted to know how much it's supplemented with, I would look at the label [the supplemented box] to see how much was in there." •Appraisal of Supplemented Foods -"I don't know, am I supposed to have 225 mg of vitamin C or not? I don't know, people don't know that right off the top of their head […] So if they are warning you [in the caution box] that with this amount of vitamins, you should probably either drink this or have a multi [multivitamin], don't do both. And I thought that was pretty good personally." Health intermediaries and consumers of varying health literacy levels were recruited with a convenience sampling strategy to participate in individual interviews or discussion groups. Health intermediaries included exercise professionals, food/nutrition professionals, medical professionals and complementary and alternative medicine specialists. Consumers included seniors, parents and physically active individuals of varying health literacy (HL) levels, as assessed by the Newest Vital Sign (2).

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