In Chile, boxes of Trix have lost their cartoon rabbits and gained black warning labels as part of an effort to limit marketing of unhealthy foods to children. In other countries, packaged foods feature stoplight color coding to indicate their relative nutritional value.
The strategies are aimed at combating the ongoing obesity epidemic. According to data from the Organization for Economic Cooperation and Development, Chile is among the top 10 countries with the highest adult obesity rates in the world. The U.S. tops the chart. Obesity rates in America are at an all-time high; over one-third of adults in America are obese, and nearly twenty percent of youth are, according to data from the U.S. Centers for Disease Control and Prevention.
Despite this trend, in current North American Free Trade Agreement talks, the Office of the United States Trade Representative is trying to limit consumer warnings on junk food. The New York Times reports that this stance “reflects the desires of a broad coalition of soft-drink and packaged-foods manufacturers in the United States,” including the Grocery Manufacturers Association. According to the Times, a spokesman for the group doubted the “evidence and impact” of food labeling regulations in Chile.
Do food labels work? Are certain labeling strategies more effective than others? We combed through the research to highlight recent studies that explore the effects of food labeling campaigns on consumer perceptions and purchases.
“Comparing Five Front-of-Pack Nutrition Labels’ Influence on Consumers’ Perceptions and Purchase Intentions”
Gorski Findling, Mary T.; et al. Preventive Medicine, 2018. DOI: 10.1016/j.ypmed.2017.10.022.
Abstract: “In 2011, a National Academy of Medicine report recommended that packaged food in the U.S. display a uniform front-of-package nutrition label, using a system such as a 0–3 star ranking. Few studies have directly compared this to other labels to determine which best informs consumers and encourages healthier purchases. In 2013, we randomized adult participants (N = 1,247) in an Internet-based survey to one of six conditions: no label control; single traffic light; multiple traffic light; Facts Up Front; NuVal; or 0–3 star ranking. We compared groups on purchase intentions and accuracy of participants’ interpretation of food labels. There were no differences in the nutritional quality of hypothetical shopping baskets across conditions (p = 0.845). All labels improved consumers’ abilities to judge the nutritional quality of foods relative to no label, but the best designs varied by outcomes. NuVal and multiple traffic light labels led to the greatest accuracy identifying the healthier of two products (p < 0.001), while the multiple traffic light also led to the most accurate estimates of saturated fat, sugar, and sodium (p < 0.001). The single traffic light outperformed other labels when participants compared nutrient levels between similar products (p < 0.03). Single/multiple traffic light and Facts Up Front labels led to the most accurate calories per serving estimations (p < 0.001). Although front-of-package labels helped participants more accurately assess products’ nutrition information relative to no label, no conditions shifted adults’ purchase intentions. Results did not point to a clearly superior label design, but they suggest that a 3-star label might not be best for educating consumers.”
“Do Nutrition Labels Influence Healthier Food Choices? Analysis of Label Viewing Behavior and Subsequent Food Purchases in a Labelling Intervention Trial”
Ni Mhurchu, Cliona; Eyles, Helen; Jiang, Yannan; Blakely, Tony. Appetite, 2018. DOI: 10.1016/j.appet.2017.11.105.
Conclusions: “In a secondary analysis of a nutrition labelling intervention trial, there was a significant association between label use and the healthiness of products purchased. Nutrition label use may therefore lead to healthier food purchases.”
“Impact of Explained v. Unexplained Front-of-Package Nutrition Labels on Parent and Child Food Choices: A Randomized Trial”
Graham, Dan J.; et al. Public Health Nutrition, 2017. DOI: 10.1017/S1368980016002676.
Abstract: “The present study investigated whether parent/child pairs would select more healthful foods when: (i) products were labelled with front-of-package (FOP) nutrition labels relative to packages without labels; (ii) products were labelled with color-coded Multiple Traffic Light (MTL) FOP labels relative to monochromatic Facts up Front (FuF) FOP labels; and (iii) FOP labels were explained via in-aisle signage v. unexplained. … Results did not support the hypothesis that MTL labels would lead to more healthful choices than FuF labels. The presence of FOP labels did little to improve the healthfulness of selected foods, with few exceptions (participants with v. without access to FOP labels selected lower-calorie cereals, participants with access to both FOP labels and in-aisle explanatory signage selected products with less saturated fat v. participants without explanatory signage).”
“The Types and Aspects of Front-of-Pack Food Labelling Schemes Preferred by Adults and Children”
Pettigrew, Simone; et al. Appetite, 2017. DOI: 10.1016/j.appet.2016.11.034.
Abstract: “There is strong interest in front-of-pack labels (FoPLs) as a potential mechanism for improving diets, and therefore health, at the population level. The present study examined Australian consumers’ preferences for different types and attributes of FoPLs to provide additional insights into optimal methods of presenting nutrition information on the front of food packets. Much research to date has focused on two main types of FoPLs — those expressing daily intake values for specific nutrients and those utilizing ‘traffic light’ color coding. This study extends this work by: (i) including the new Health Star Rating system recently introduced in Australia and New Zealand; (ii) allowing a large sample of consumers to self-nominate the evaluation criteria they consider to be most important in choosing between FoPLs; (iii) oversampling consumers of lower socioeconomic status; and (iv) including children, who consume and purchase food in their own right and also influence their parents’ food purchase decisions. A cross-sectional online survey of 2,058 Australian consumers (1,558 adults and 500 children) assessed preferences between a daily intake FoPL, a traffic light FoPL, and the Health Star Rating FoPL. Across the whole sample and among all respondent subgroups (males vs females; adults vs children; lower socioeconomic status vs medium-high socioeconomic status; normal weight vs overweight/obese), the Health Star Rating was the most preferred FoPL (44 percent) and the daily intake guide was the least preferred (20 percent). The reasons most commonly provided by respondents to explain their preference related to ease of use, interpretive content, and salience. The findings suggest that a simple to use, interpretive, star-based food label represents a population-based nutrition promotion strategy that is considered helpful by a broad range of consumers.”
“Impact of Food Labelling Systems on Food Choices and Eating Behaviors: A Systematic Review and Meta-Analysis of Randomized Studies: Impact of Food Labelling”
Cecchini, M.; Warin, L. Obesity Reviews, 2016. DOI: 10.1111/obr.12364.
Summary: “Food labels are considered a crucial component of strategies tackling unhealthy diets and obesity. This study aims at assessing the effectiveness of food labelling in increasing the selection of healthier products and in reducing calorie intake. In addition, this study compares the relative effectiveness of traffic light schemes, Guideline Daily Amount and other food labelling schemes. A comprehensive set of databases were searched to identify randomized studies. Studies reporting homogeneous outcomes were pooled together and analyzed through meta‐analyses. Publication bias was evaluated with a funnel plot. Food labelling would increase the amount of people selecting a healthier food product by about 17.95 percent (confidence interval: +11.24 percent to +24.66 percent). Food labelling would also decrease calorie intake/choice by about 3.59 percent (confidence interval: −8.90 percent to +1.72 percent), but results are not statistically significant. Traffic light schemes are marginally more effective in increasing the selection of healthier options. Other food labels and Guideline Daily Amount follow. The available evidence did not allow studying the effects of single labelling schemes on calorie intake/choice. Findings of this study suggest that nutrition labelling may be an effective approach to empowering consumers in choosing healthier products. Interpretive labels, as traffic light labels, may be more effective.”
“Impact of Different Front-of-Pack Nutrition Labels on Consumer Purchasing Intentions”
Ducrot, Pauline; et al. American Journal of Preventive Medicine, 2016. DOI: 10.1016/j.amepre.2015.10.020.
Summary: “The intervention was to simulate one shopping situation with front-of-pack nutrition labels affixed on food products (December 2014 to March 2015). Participants were randomly assigned to one of five exposure conditions using a central computer system: Guideline Daily Amounts, Multiple Traffic Lights, Five-Color Nutrition Label, Green Tick, or control (no front-of-pack exposure). … A total of 11,981 participants were included in the analyses (April 2015). The Five-Color Nutrition Label significantly led to the highest overall nutritional quality of the shopping cart, as reflected by lower Food Standards Agency scores (M=8.72; SD=2.75), followed by Multiple Traffic Lights (M=8.97; SD=2.68) and Green Tick (M=8.99; SD=2.71), compared with the control (M=9.34; SD=2.57) (p<0.0001). The Five-Color Nutrition Label was the only front-of-pack format that led to a lower content in lipids, saturated fatty acids, and sodium of the shopping cart (all p<0.05). The impact of the different front-of-pack labels was similar across sociodemographic subgroups.”
“Does the Australasian ‘Health Star Rating’ Front of Pack Nutritional Label System Work?”
Hamlin, Robert; McNeill, Lisa. Nutrients, 2016. DOI: 10.3390/nu8060327.
Abstract: “This article describes an experiment to measure the impact of the Australasian ‘Health Star Rating’ front of pack nutritional label system on consumer choice behavior. This system presents a one-half to five star rating of nutritional quality via the front facings of food product packages. While this system has been recently rolled out across Australasia, no test of its impact on food choice has been conducted. A sample of 1,200 consumers was recruited on exit from supermarkets in New Zealand. A 2 × 2 factorial design was used with two levels of cold cereal product nutritional status (high, five star/low, two star) and two levels of the Health Star Rating label (present/absent). The dependent variable was revealed choice behavior. The results indicated that the presence of the label had a significant depressive effect on consumer preference, but that this impact was not moderated in any way by the nutritional status expressed by the label. The result represents a significant functional failure of the Health Star Rating label in this research environment. The nature of the failure is consistent with the consumers processing the label in much the same way as the nominal brand cues that dominate the retail food packaging.”
“Using Traffic Light Labels to Improve Food Selection in Recreation and Sport Facility Eating Environments”
Olstad, Dana Lee; et al. Appetite, 2015. DOI: 10.1016/j.appet.2015.04.057.
Abstract: “Many recreation and sports facilities have unhealthy food environments, however managers are reluctant to offer healthier foods because they perceive patrons will not purchase them. Preliminary evidence indicates that traffic light labeling (TLL) can increase purchase of healthy foods in away-from-home food retail settings. We examined the effectiveness of TLL of menus in promoting healthier food purchases by patrons of a recreation and sport facility concession, and among various sub-groups. TLL of all menu items was implemented for a 1-week period and sales were assessed for 1-week pre- and 1-week post-implementation of TLL (n = 2,101 transactions). A subset of consumers completed a survey during the baseline (n = 322) and intervention (n = 313) periods. We assessed change in the proportion of patrons’ purchases that were labeled with green, yellow and red lights from baseline to the TLL intervention, and association with demographic characteristics and other survey responses. Change in overall revenues was also assessed. There was an overall increase in sales of green (52.2 percent to 55.5 percent; p < 0.05) and a reduction in sales of red (30.4 percent to 27.2 percent; p < 0.05) light items from baseline to the TLL period. The effectiveness of TLL did not differ according to any of the demographic or other factors examined in the survey. Average daily revenues did not differ between the baseline and TLL periods. TLL of menus increased purchase of healthy, and reduced purchase of unhealthy foods in a publicly funded recreation and sport facility, with no loss of revenue. Policymakers should consider extending menu labeling laws to public buildings such as recreation and sports facilities to promote selection of healthier items.”
“Interpretive Front-of-Pack Nutrition Labels. Comparing Competing Recommendations”
Maubach, Ninya; Hoek, Janet; Mather, Damien. Appetite, 2014. DOI: 10.1016/j.appet.2014.07.006.
Abstract: “This study used a best-worst scaling choice experiment to estimate how labels featuring the new Star rating, the Multiple Traffic Light (MTL), Daily Intake Guide (DIG), and a no-FOP control affected consumers’ choice behaviors and product perceptions. Nutrient-content and health claims were included in the design. We also assessed whether respondents who used more or less information during the choice tasks differed in their selection patterns. Overall, while respondents made broadly similar choices with respect to the MTL and Star labels, the MTL format had a significantly greater impact on depressing preference as a food’s nutritional profile became less healthy. Health claims increased rankings of less nutritious options, though this effect was less pronounced when the products featured an MTL. Further, respondents were best able to differentiate products’ healthiness with MTL labels. The proposed summary Stars system had less effect on choice patterns than an MTL label and our findings highlight the need for policy makers to ensure that decisions to introduce FOP labels are underpinned by robust research evidence. These results suggest that the proposed summary Stars system will have less effect on shifting food choice patterns than interpretive FOP nutrition label featuring traffic light ratings.”
“Traffic-Light Labels and Choice Architecture”
Thorndike, Anne N.; Riis, Jason; Sonnenberg, Lillian; Levy, Douglas. American Journal of Preventive Medicine, 2014. DOI: 10.1016/j.amepre.2013.10.002.
Conclusions: “A traffic-light and choice architecture cafeteria intervention resulted in sustained healthier choices over 2 years, suggesting that food environment interventions can promote long-term changes in population eating behaviors.”
“Can Front-of-Pack Labelling Schemes Guide Healthier Food Choices? Australian Shoppers’ Responses to Seven Labelling Formats”
Watson, Wendy L., et al. Appetite, 2014. DOI: 10.1016/j.appet.2013.09.027.
Abstract: “There is evidence that easily accessible, comprehensible and consistent nutrient information on the front of packaged foods could assist shoppers to make healthier food choices. This study used an online questionnaire of 4,357 grocery shoppers to examine Australian shoppers’ ability to use a range of front-of-pack labels to identify healthier food products. Seven different front-of-pack labelling schemes comprising variants of the Traffic Light labelling scheme and the Percentage Daily Intake scheme, and a star rating scheme, were applied to nine pairs of commonly purchased food products. Participants could also access a nutrition information panel for each product. Participants were able to identify the healthier product in each comparison over 80 percent of the time using any of the five schemes that provided information on multiple nutrients. No individual scheme performed significantly better in terms of shoppers’ ability to determine the healthier product, shopper reliance on the ‘back-of-pack’ nutrition information panel, and speed of use. The scheme that provided information about energy only and a scheme with limited numerical information of nutrient type or content performed poorly, as did the nutrition information panel alone (control). Further consumer testing is necessary to determine the optimal format and content of an interpretive front-of-pack nutrition labelling scheme.”
“A Traffic Light Food Labeling Intervention Increases Consumer Awareness of Health and Healthy Choices at the Point-of-Purchase”
Sonnenberg, Lillian; et al. Preventive Medicine, 2013. DOI: 10.1016/j.ypmed.2013.07.001.
Conclusions: “Traffic light food labels prompted individuals to consider their health and to make healthier choices at point-of-purchase.”