Are Front-of-Package Warning Labels More Effective at Communicating Nutrition Information than Traffic-Light Labels? A Randomized Controlled Experiment in a Brazilian Sample

Khandpur, Neha; Sato, Priscila de Morais; Mais, Laís Amaral; Martins, Ana Paula Bortoletto; Spinillo, Carla Galvão; Garcia, Mariana Tarricone; Rojas, Carlos Felipe Urquizar; Jaime, Patrícia Constante

doi:10.3390/nu10060688

Cited by 157 publications

(165 citation statements)

References 29 publications

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“…Taken together, our findings from a large sample of Brazilian packaged foods and beverages, sold in supermarkets in the country that control 70% of the retail market share contribute to the literature by showing the pervasive presence of nutrition and health claims in unhealthy products, even more so among those highly consumed by children and adolescents [2,25,40]. Although FoP labeling in the format of warning signs seems to be effective in nudging consumers to choose healthier products [8,11,14,43], when these signs are accompanied by nutrition claims for the same nutrient for which a warning sign is present in the package, this can undermine the efficacy of FoP labeling [17]. Health and nutrition claims have been associated with purchase behavior [44].…”

Section: Discussionsupporting

confidence: 55%

“…Similar to the Chilean FoP warning label system, as well as systems adopted in Uruguay, Peru, and currently under final discussions in Mexico and Canada, the proposed labels in Brazil will be able to identify unhealthy foods only and would be applied to products containing excessive levels of added sugar, saturated fat, and sodium with the words "high in (sugar, saturated fat, or sodium)" [6]. Warning labels have been shown to be easier to understand than competing systems such as the traffic light among various groups, including Brazilians [7,8]. In the same proposal, Anvisa lays out options for restricting the use of nutrition claims in foods high in critical nutrients [9].…”

Section: Introductionmentioning

confidence: 99%

“…These proposed regulations have the potential to substantially alter the Brazilian food supply as well as consumers' understanding, perceptions, purchase intentions, and intake of UPF. A recent randomized controlled trial in Brazil found that the exposure to FoP warning labels that only identify unhealthy foods helped consumers understand the unhealthiness of UPF and reduced their intentions to purchase this food [8], consistent with a growing body of literature that shows that warning labels improve consumers' ability to assess the healthfulness of products [10,11] and help them make healthier choices [12][13][14][15]. Conversely, nutrition and health claims have been shown to make consumers think a product is healthier than it actually is, working as a marketing strategy rather than an information tool (i.e., the "health halo" effect) [16,17].…”

Section: Introductionmentioning

confidence: 99%

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Conflicting Messages on Food and Beverage Packages: Front-of-Package Nutritional Labeling, Health and Nutrition Claims in Brazil

et al. 2019

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We assessed the prevalence of front-of-package (FoP) claims in the Brazilian packaged food supply and examined whether foods with claims were more likely to be high in critical nutrients. Using data from a random 30% subsample of 11,434 foods and beverages collected in the five largest food retailers in Brazil in 2017 (n = 3491), we classified claims into nutrition, health, and environment. We examined whether foods with claims were more likely to be high in critical nutrients using 95% confidence intervals. Claims were found in 41.2% of the products. Nutrition claims were the most prevalent (28.5%), followed by health (22.1%), and environment-related claims (5.2%). More than 85% of the breakfast cereals, granola bars, and nectars contained claims, which were found in 51% of the dairy beverages. Foods with nutrition claims were more likely to be high in critical nutrients (65.3%; 95% CI 62.3, 68.2% vs. 54.1% 95% CI 52.1, 56.0). Products with health (52.9%; 95% CI 49.3, 56.4% vs. 58.5%; 95% CI 56.6, 60.3) and environment-related claims (33.5%; 95% CI 27.0, 40.8% vs. 58.6%; 95% CI 56.9, 60.2%) were less likely to be high in critical nutrients. FoP claims are prevalent in Brazil, and nutrition claims are more likely to have a poorer nutritional profile. Policymakers should consider restricting the presence of claims on unhealthy products.

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Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Conflicting Messages on Food and Beverage Packages: Front-of-Package Nutritional Labeling, Health and Nutrition Claims in Brazil

et al. 2019

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“…The WL design alerts the consumer to products whose ingredients contribute to an excess of sodium, sugars, or fats, with individual WLs present for every nutrient in excess. WLs are also easier to interpret than other labels , with multiple WLs reiterating consistent information and implicitly encouraging consumers, both adults and children, to seek foods with fewer or no WLs.…”

Section: Warning Labels Are Consistent In the Information They Communmentioning

confidence: 99%

Nutrient‐Based Warning Labels May Help in the Pursuit of Healthy Diets

Khandpur

Swinburn

Monteiro

2018

Obesity

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In this commentary we argue that the newest paradigm of front‐of‐package labels, represented by the characteristics found in the Chilean warning label, has the greatest potential to promote healthy diets compared with the Keyhole symbol, the multiple traffic light label, the Health Star Ratings system, and the 5‐Color Nutrition label. Warning labels: (1) are consistent in the information they communicate; (2) discourage the purchase and consumption of noncore foods that characterize unhealthy diets; (3) are more likely to reinforce other regulatory measures; and (4) are more likely to encourage reformulation and are less likely to be used as a marketing tool by the food industry. Ongoing empirical evaluation of the impact of warning labels on consumer behavior and product reformulation is essential.

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“…For example, in the Mexican National Health and Nutrition Survey Survey of 2016, only 41% declared they use the labelling . Also, there is evidence that other types of labels could be more effective …”

Section: Discussionmentioning

confidence: 99%

The INFORMAS healthy food environment policy index (Food‐EPI) in Mexico: An assessment of implementation gaps and priority recommendations

et al. 2019

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Summary Mexico is one of the countries with the highest prevalence of obesity and recently declared a national epidemic of diabetes. Healthy food environments have the potential to improve the diet of the population and decrease the burden of disease. The aim of the study was to assess the efforts of the Mexican Government towards creating healthier food environments using the Healthy Food Environment Policy Index (Food‐EPI). The tool was developed by the International Network for Food and Obesity/Non‐communicable Diseases Research, Monitoring and Action Support (INFORMAS). Then, it was adapted to the Latin‐American context and assessed the components of policy and infrastructure support. Actors from academia, civil society, government, and food industry assessed the level of implementation of food policies compared with international best practices. Actors were classified as (1) independents from academia and civil society (n = 36), (2) government (n = 28), and (3) industry (n = 6). The indicators with the highest percentage of implementation were those related to monitoring and intelligence. Those related to food retail were rated lowest. When stratified by type of actor, the government officials rated several indicators at a higher percentage of implementation compared with independent actors. None of the indicators were rated at high implementation. Government officials and independent actors agreed upon nine priority actions to improve the food environment in Mexico. These actions have the potential to improve government commitment and advocacy efforts to create healthier food environments.

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Are Front-of-Package Warning Labels More Effective at Communicating Nutrition Information than Traffic-Light Labels? A Randomized Controlled Experiment in a Brazilian Sample

Cited by 157 publications

References 29 publications

Conflicting Messages on Food and Beverage Packages: Front-of-Package Nutritional Labeling, Health and Nutrition Claims in Brazil

Conflicting Messages on Food and Beverage Packages: Front-of-Package Nutritional Labeling, Health and Nutrition Claims in Brazil

Nutrient‐Based Warning Labels May Help in the Pursuit of Healthy Diets

The INFORMAS healthy food environment policy index (Food‐EPI) in Mexico: An assessment of implementation gaps and priority recommendations

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