Impact of front-of-pack labels on the perceived healthfulness of a sweetened fruit drink: a randomised experiment in five countries

Abstract

Objective: Front-of-pack (FOP) nutrition labelling is a globally recommended strategy to encourage healthier food choices. We evaluated the effect of FOP labels on the perceived healthfulness of a sweetened fruit drink in an international sample of adult consumers. Design: Six-arm randomised controlled experiment to examine the impact of FOP labels (no label control, Guideline Daily Amounts (GDA), Multiple Traffic Lights, the Health Star Ratings (HSR), Health Warning Labels, and ‘High-in’ Warning Labels (HIWL)) on the perceived healthfulness of the drink. Linear regression models by country examined healthfulness perceptions on FOP nutrition labels, testing for interactions by demographic characteristics. Setting: Online survey in 2018 among participants from Australia, Canada, Mexico, United Kingdom (UK) and United States. Participants: Adults (≥18 years, n 22 140). Results: Compared with control, HIWL had the greatest impact in lowering perceived healthfulness (β from −0·62 to −1·71) across all countries. The HIWL and the HSR had a similar effect in Australia. Other labels were effective in decreasing the perceived healthfulness of the drink within some countries only, but to a lower extent. The GDA did not reduce perceived healthfulness in most countries. In the UK, the effect of HIWL differed by age group, with greater impact among older participants (> 40 years). There were no other variations across key demographic characteristics. Conclusions: HIWL, which communicates clear, non-quantitative messages about high levels of nutrients of concern, demonstrated the greatest efficacy to decrease the perceived healthfulness of a sweetened fruit drink across countries. This effect was similar across demographic characteristics.

Effects of front-of-package nutrition labelling systems on understanding and purchase intention in Jamaica: results from a multiarm randomised controlled trial

“…This information is expected to require more time and cognitive effort to interpret compared with the OWL or MGG, as reported in previous studies based on response times 43 49. Previous studies have also shown that the use of green colour found in systems such as the TFL and Nutri-Score may drive consumers to misperceive a product as healthier and undesirably raise their appetite for such products, which may explain their lower effect on understanding of nutritional information and purchase intention 49 51–61. In addition, the use of red colour, also found in such systems, although intended to communicate a higher harmfulness level, may trigger an opposite effect in some products.…”

Effects of front-of-package caffeine and sweetener disclaimers in Mexico: cross-sectional results from the 2020 International Food Policy Study

“…Among adults, sweetener disclaimers led to a lower perceived healthfulness of the sugary drink among older compared with younger participants. Similarly, a larger effect of warning labels on the perceived healthfulness ratings of a sugary drink was observed among older adults than younger adults from the UK (34) . It has been stated that older adults have greater health risk perceptions (how individuals subjectively estimate and feel about the risks they face) compared with their younger counterparts (35,36) .…”

Exploring the perception of small and medium food enterprises in Lincolnshire, UK on the use of front‐of‐pack nutrition labels by consumers

“…UK consumers utilise the information on the FOP and BOP nutrition labels during food shopping to monitor what they will purchase (Kelly & Jewell, 2019; Department of Health and Social Care (DHSC), 2020; Bhawra et al ., 2022). This is the same in the United States, Australia and elsewhere (Dickie et al ., 2018; Jones et al ., 2019; Jáuregui et al ., 2022).…”