Assessment of the knowledge, attitudes and practices of Lebanese shoppers towards food labeling: The first steps in the Nutri-score roadmap

Abstract

Background: Food labeling is a fundamental educational tool for advocating for public awareness. It emphasizes knowledge of the nutrient content of food and thus directs the choice towards the healthiest food products. This cross-sectional survey aimed to assess the knowledge, attitudes, and practices (KAP) regarding nutrition label use in Lebanon through a valid questionnaire. Methods: Overall, 768 participants (mean age: 30.8 ±12, males: 60.2%) were recruited randomly between February and May 2020. We used word of mouth and social media to recruit our sample population. Results: Social media was the most accessed tool to attain nutrition information by responders (39.8%). More than half the participants expressed positive attitudes to check information related to sugars (66.4%), vitamins (64.9%), total fats (61.7%), proteins (59.1%), and calories (58.7%) on the food label. Expiry date, price, and brand name were the top three considerations while reading food labels. About half (46.5%) reported to “always” look at the food label. Responders reported reading labels related primarily to sugars (44.3%), calories (38.8%), and total fats (36.8%). The optimal total KAP score was 46; our findings revealed a mean KAP score of 14.46 ±7 (31.4%). When categorizing the KAP scores, 15% had high scores, and 85% scored low. Spearman’s coefficients showed positive correlations between knowledge-attitude, knowledge-practice, and attitude-practice scores, with p<0.001. The regression analysis revealed that gender, age, BMI, residency area, educational level, university degree, health and diet statuses, and activity level were significant predictors of the KAP score. Being on a diet had the highest odds (OR=3.107, CI=1.904-5.072, p<0.001). Conclusion: The low awareness of food labels leads Lebanese people to choose unhealthy food options. A planned educational program is recommended to ease the interpretation of these labels.

The correlation between knowledge and behavior of reading composition label of packaged food on public 2 JHS and Giovani JHS students in Kupang

“…This is in accordance with the research conducted by Vania Candra et al 24 , which showed that there was a significant relationship between the respondents level of knowledge about reading packaged food labels and the practice of choosing packaged food, where respondents with very good knowledge will practice good packaged food selection. This is also supported by research conducted by Maha Hoteit et al 25 , where there is a positive relationship between knowledge and buyer behaviour in Lebanon in reading packaged food labels when buying packaged food.…”

Nutrition and Food Literacy in the MENA Region: A Review to Inform Nutrition Research and Policy Makers

“…One possible explanation for observing such findings in the MENA countries is that this concept and its application have neither been entered into school curricula and textbooks nor in education programs, to empower individuals in basing their food choices according to nutrition- and safety-related considerations. One recent study showed that Lebanese shoppers expressed poor nutrition-label-related knowledge, and more than half the population either read nutrition labels occasionally or did not look at the food label at all [ 82 ]. Emirati consumers reported looking mostly at the expiration date of the products rather than the information related to the food-storage and -handling instructions and the biotechnology as well, which are key components of being food literate [ 83 ].…”

“…Food-literacy interventions focusing on consumer’ skills to read food labels should be prioritized in such regions, where nutrition inadequacy and malnutrition are not uncommon. Thereupon, Hoteit M. and colleagues (2022) [ 82 ] provided data on this topic, “the first steps in the Nutri-Score roadmap”, to serve as an initiative to motivate the national implementation of food-labeling approaches in Lebanon such as the Nutri-Score front-of-pack label.…”

Sugar Reduction Initiatives in the Eastern Mediterranean Region: A Systematic Review

“…As for data on KAB, this information was available in 10 EMR countries (45%), including Bahrain, Egypt, Iran, Jordan, KSA, Kuwait, Lebanon, Morocco, Oman and Pakistan. The majority of KAB surveys included questions related to (1) knowledge of sugar food sources, sugar content in food products, and familiarity with adverse weight/health effects of high sugar intakes; (2) consumer’s attitude such as importance of restricting/limiting the intake of sugar, making healthier choices and checking information related to sugar; and (3) consumers’ behavior such as consuming high sugar food products, reducing the amount of AS, substituting high-sugar options with healthier options and reading labels ( Table S7 ) [ 72 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 ]. Poor knowledge related to sugar food sources and content was reported from more than 65% of school-aged children in Jazan, KSA [ 98 ].…”

“…In addition, 77.5% of male schoolchildren in Riyadh, KSA [ 100 ], 61% of college students in Muscat, Oman [ 107 ] and 85% of adults in Rawalpindi cantonment in Pakistan [ 111 ], were unaware of the adverse health effects of high sugar consumption. A national study in Lebanon showed that less than 50% of adolescents and adults did not know what a “sugar-free” claim indicates [ 116 ]. As for attitude, more than 80% of schoolchildren in Jazan, KSA preferred high sugar foods and beverages, as compared to healthier options [ 98 ].…”