Efficacy of “High in” Nutrient Specific Front of Package Labels—A Retail Experiment with Canadians of Varying Health Literacy Levels

Abstract

Background: In 2018, Health Canada, the Federal department responsible for public health, put forward a regulatory proposal to introduce regulations requiring a “High in” front-of-package label (FOPL) on foods that exceed predetermined thresholds for sodium, sugars, or saturated fat. This study evaluated the efficacy of the proposed FOPL as a quick and easy tool for making food choices that support reduction in the intakes of these nutrients. Methods: Consumers (n = 625) of varying health literacy levels (HL) were assigned to control (current labeling with no FOPL) or one of four FOPL designs. They completed six shopping tasks, designed to control for internal motivations. Efficacy was measured with correct product selection and response time (seconds) to make food choices using repeated measures statistical modeling, adjusting for HL, task type, and task order. Eye-tracking and structured interviews were used to gather additional insights about participants’ choices. Results: Overall, FOPL was significantly more effective than current labeling at helping consumers of varying HL levels to identify foods high in nutrients of concern and make healthier food choices. All FOPL were equally effective. Conclusions: “High in” FOPL can be effective at helping Canadians of varying HL levels make more informed food choices in relation to sugars, sodium, and saturated fat.

Evaluating the potential implications of canadian front-of-pack labelling regulations in generic and branded food composition databases

“…The currently proposed FOP labelling regulations would mandate that foods meeting or exceeding recommended thresholds for nutrients-of-concern (i.e., total sugars, saturated fat, sodium) be required to display a 'high-in' FOP symbol [9]. Studies on Canadian consumers' responses to FOP labelling in the form of a 'high-in' FOP symbol have shown the potential decreases in preference for and purchasing intentions of foods and beverages with a FOP symbol [10][11][12][13][14][15]. Although branded food composition databases in Canada have been used to evaluate the levels of specific nutrients-of-concern [16][17][18][19][20], and for testing the potential impact of the proposed FOP labelling regulations on a subsample of products from specific food companies [18], an examination of the FOP labelling regulations using on a broader sample of food and beverage products available to Canadian consumers is warranted.…”

A comparative assessment of two different front-of-package nutrition label designs: A randomized experiment in Brazil

“…The similarity in the performance between the ML and the TL in helping to identify nutrient content above nutritional recommendations has been shown in two other studies [ 25 , 31 ]. A Canadian study showed the ML as being superior to a no-label control in helping participants identify foods high in saturated fat, sugars, and/or sodium [ 27 ]. However, a different study conducted with a different Canadian sample found that the ML was no different from a no-label control in helping participants identify the product with an excess of saturated fat or sugar [ 30 ].…”

“…Along with the octagon, the triangle model has been studied in some detail and found to be a robust choice for the Brazilian population [ 24 , 25 ]. The magnifying glass model with the text ‘High in [X nutrient], put forth by Anvisa in 2020 as the FoP label for Brazil [ 26 ], has not been researched as extensively [ 27 ]. This study was conducted to provide more evidence on the relative utility of the magnifying glass model.…”

Health Literacy and Its Associations with Understanding and Perception of Front-of-Package Nutrition Labels among Higher Education Students

“…Young adults, who have been highlighted as a specific group regarding HL and its determinants throughout the literature [ 42 , 44 ], could benefit from FOP labels for their own health. Recently, the “High in” FOPL was shown to be significantly more effective than current regulated labeling in helping Canadian consumers of varying HL levels to identify foods high in nutrients related to public health concerns [ 45 ].…”