Nutritional labelling for healthier food or non-alcoholic drink purchasing and consumption

Abstract

Background Nutritional labelling is advocated as a means to promote healthier food purchasing and consumption, including lower energy intake. Internationally, many different nutritional labelling schemes have been introduced. There is no consensus on whether such labelling is effective in promoting healthier behaviour. Objectives To assess the impact of nutritional labelling for food and non‐alcoholic drinks on purchasing and consumption of healthier items. Our secondary objective was to explore possible effect moderators of nutritional labelling on purchasing and consumption. Search methods We searched 13 electronic databases including CENTRAL, MEDLINE and Embase to 26 April 2017. We also handsearched references and citations and sought unpublished studies through websites and trials registries. Selection criteria Eligible studies: were randomised or quasi‐randomised controlled trials (RCTs/Q‐RCTs), controlled before‐and‐after studies, or interrupted time series (ITS) studies; compared a labelled product (with information on nutrients or energy) with the same product without a nutritional label; assessed objectively measured purchasing or consumption of foods or non‐alcoholic drinks in real‐world or laboratory settings. Data collection and analysis Two authors independently selected studies for inclusion and extracted study data. We applied the Cochrane 'Risk of bias' tool and GRADE to assess the quality of evidence. We pooled studies that evaluated similar interventions and outcomes using a random‐effects meta‐analysis, and we synthesised data from other studies in a narrative summary. Main results We included 28 studies, comprising 17 RCTs, 5 Q‐RCTs and 6 ITS studies. Most (21/28) took place in the USA, and 19 took place in university settings, 14 of which mainly involved university students or staff. Most (20/28) studies assessed the impact of labelling on menus or menu boards, or nutritional labelling placed on, or adjacent to, a range of foods or drinks from which participants could choose. Eight studies provided participants with only one labelled food or drink option (in which labelling was present on a container or packaging, adjacent to the food or on a display board) and measured the amount consumed. The most frequently assessed labelling type was energy (i.e. calorie) information (12/28). Eleven studies assessed the impact of nutritional labelling on purchasing food or drink options in real‐world settings, including purchases from vending machines (one cluster‐RCT), grocery stores (one ITS), or restaurants, cafeterias or coffee shops (three RCTs, one Q‐RCT and five ITS). Findings on vending machines and grocery stores were not interpretable, and were rated as very low quality. A meta‐analysis of the three RCTs, all of which assessed energy labelling on menus in restaurants, demonstrated a statistically signific...

Impact of low alcohol verbal descriptors on perceived strength: An experimental study

“…Labels indicating low or light versions of products with health harms (e.g., high fat foods and tobacco) suggest the potential for unintended paradoxical effects, including greater appeal and consumption of total calories when foods are labelled ‘low fat’, and perceived lower harm from cigarettes labelled as ‘light’ (Borland et al ., ; Hammond & Parkinson, ; Kozlowski & Pillitteri, ; Kozlowski et al ., ; McCann et al ., ; Wansink & Chandon, ). For example, foods labelled low fat gain a ‘health halo’ which leads consumers to prefer these products and consume more calories than when presented with the same foods without the labels (Crockett et al ., under review; McCann et al ., ). This self‐licensing effect for overconsumption is most pronounced amongst high consumers (Wansink & Chandon, ).…”

British Nutrition Foundation Annual Lecture 2017 – Diet, obesity and cardiovascular risk

“…) and trials to test the effectiveness of nutritional labels (Crockett et al . ). She also described the importance of presenting evidence to policymakers in an appropriate format and the value of skilled knowledge brokers.…”

“…Developing population level interventions largely requires engagement and action by policymakers but researchers have a role in developing the evidence base for these actions and evaluating their effectiveness. Professor Jebb gave examples from her work of modelling studies to examine the likely impacts of a tax on sugarssweetened beverages (Briggs et al 2017;Quirmbach et al 2018) and trials to test the effectiveness of nutritional labels (Crockett et al 2018). She also described the importance of presenting evidence to policymakers in an appropriate format and the value of skilled knowledge brokers.…”

Seven days in medicine: 21-27 February 2018

“…Adding nutritional labelling to menus may reduce the calories people consume, evidence published in the Cochrane Library showed 2. A systematic review of several studies to have looked at the impact of nutritional labels on food and non-alcoholic drinks found that adding calorie labels to menus and next to food in restaurants, coffee shops, and cafes can have an effect.…”