Consumption of foods with the Keyhole front-of-pack nutrition label: potential impact on energy and nutrient intakes of Swedish adolescents

Abstract

Objective: The Keyhole is an internationally recognized front-of-pack nutrition label, guiding consumers to healthier food options. It indicates products in accordance with specific criteria for dietary fats, sugars, fibres, salt, and whole grains. The objective of this study was to simulate the potential impact of the Keyhole on adolescents’ energy and nutrient intakes by modelling a shift from reported food intakes to foods meeting the Keyhole criteria. Design: Self-reported dietary intake data were derived from a cross-sectional survey. Multiple replacement scenarios were calculated, where foods meeting the Keyhole criteria replaced reported noncompliant foods with varying proportions of replacement. Setting: Dietary survey “Riksmaten Adolescents 2016-17” in schools across Sweden. Participants: A nationally representative sample of 3099 adolescents in school years 5, 8 and 11 (55% girls). Results: Overall, replacement with foods meeting the Keyhole criteria led to more adolescents meeting nutrition recommendations. Largest median intake improvements were seen for whole grains (+196%), saturated fats (-13%), polyunsaturated fats (+17%), and fibres (+15%). Smallest improvements were seen for free sugars (-3%) and salt (-2%), partly explained by the ineligibility of main food sources of free sugars for the Keyhole, and non-inclusion of ready meals that are often high in salt. Most micronutrient intakes were stable or improved. Unintentional effects included decreases in vitamin A, monounsaturated fats, and energy intakes. Largest potential improvements in fat and fibre sources were observed in the youngest age group. Conclusions: A shift to Keyhole alternatives for everyday foods would improve adolescents’ nutrient intakes, even with smaller exchanges.

Brazilian Front-of-Package Labeling: A Product Compliance Analysis 12 Months after Implementation of Regulations

“…Historically, one of the first countries to adopt a front-of-package nutrition labeling model was Sweden in 1989. As a government initiative and of voluntary adoption, the country approved the so-called "keyhole", a lock symbol that identified healthier options within different categories of food products [21,22].…”

“…Due to its effectiveness, other countries also began to adopt this tool, such as Denmark and Norway in 2009 and Iceland and Lithuania in 2014 [21,23]. Another important and well-known model is the nutritional "traffic light", which uses colors to help understand the level of each nutrient in food (high, medium, or low).…”

The Role of Front-of-Package Nutrition Labels with and without Explanatory Videos on Parent and Child Food Choices

“…Front-of-package nutrition labeling remains a policy priority in the United States, and there is evidence from other countries that nationally mandated labels can have beneficial effects on public health nutrition (e.g., [ 48 , 49 , 50 , 51 ]). However, the evidence from this study suggests that the labels tested here may not be optimal for increasing healthfulness of products selected by parents and children choosing foods together.…”

Predicting willingness to consume healthy brand foods using the theory of planned behavior: the role of nutritional literacy

“…People’s willingness to consume healthy brand-name foods can vary widely due to some factors, including personal preferences, purchasing power, health awareness, nutritional information and labeling, lifestyle, and dietary choices, price and availability, brand reputation, and cultural and social trends ( 8 ). Previous literature recognized a significant association between the willingness to consume foods from healthy brands with nutritional information and labeling since having clear and transparent information about the ingredients and nutrition of the product or food can influence purchasing decisions ( 9 , 10 ). Brands that emphasize health attributes can attract health-conscious consumers ( 11 , 12 ).…”