Food Label Literacy and Use among US Adults Diagnosed with Cancer: Results from a National Representative Study

Abstract

For those diagnosed with cancer, lifestyle factors including diet can be more important than ever. However, lack of nutrition-related knowledge can pose a significant barrier to healthy eating. Food labels guide consumers in selecting appropriate portion sizes-that is, caloric content-and ensuring adequate intake of nutrients. Data from the 2013-2014 HINTS were used to examine (a) differences in food label use and food label literacy between respondents ever had a cancer diagnosis and those never had a diagnosis; (b) sociodemographic correlates and health-related correlates of food label use and literacy, in a context of cancer diagnosis; and (c) potential association between food label use/literacy and each of two dietary choices, eating vegetables and fruits and limiting intake of sugary drinks, again, in a context of cancer diagnosis. Data was analyzed via SPSS version 24.0, and cross tabulations using Pearson's Chi-square test and logistic regressions. Income, gender and non-participation in support groups were associated with food label literacy (p<.05). Confidence to take care of self was associated with food label use (p<.05). Relationships were observed between using food labels and curtailing soda intake (b = -.368, p<.05), eating relatively more fruits (b = .558, p<.05), and eating relatively more vegetables (b = .558, p<.05). The overall models predicting consumption of soda [x2 (2) = 13.70, p = .001, Nagelkerke R-square = .059], of fruits [x2 (2) = 33.87, p < .001, Nagelkerke R-square = .136], and of vegetables [x2 (2) = 36.08, p < .001, Nagelkerke R-square = .144] was statistically significant. Implications for research and practice can be found in results linking food label use to better quality diets. They include the usefulness of nutrition education interventions targeting lower-income men with cancer diagnoses; one lesson should be the use of food labels.

Who Reads Food Labels? Selected Predictors of Consumer Interest in Front-of-Package and Back-of-Package Labels during and after the Purchase

“…Findings consistently support a relationship between label reading and dietary practices [22,23]. Changes in diet quality due to label use were estimated for different types of label information.…”

A Scoping Review of the Validity, Reliability and Conceptual Alignment of Food Literacy Measures for Adults

“…Included papers had four distinct purposes, those reporting the development of a tool to explicitly measure food literacy or a part thereof ( n = 5); food literacy strategy indicators ( n = 1); tools developed to evaluate a food literacy intervention ( n = 3); and tools to measure food literacy as a characteristic within a broader study ( n = 3). Most tools ( n = 7) were used to assess the food literacy of individuals or populations, including adults residing in a particular country [17,24,25,26], household food gatekeepers [28] and adults diagnosed with cancer [19]. One tool proposed key performance indicators for food literacy strategic directions in a state public health nutrition strategy [22].…”

“…One tool proposed key performance indicators for food literacy strategic directions in a state public health nutrition strategy [22]. Four were also used to compare food literacy levels between people of different socioeconomic status [19,24,25,28] and five examined the relationship between food literacy and food intake [19,26,28]. Six of the 12 identified tools were used to evaluate the effectiveness of food literacy interventions in Australia [20,21,27], Switzerland [16], Canada [22] and the United Kingdom [23].…”

“…Three studies [20,21,23] used their tool with a high proportion of participants from a low socio-economic background. Four studies were undertaken in Australia [20,21,27,28], five in Europe (France [25], Italy [17], the Netherlands [26], Switzerland [16], the United Kingdom [23]), one in Canada [22] and two were in the United States [19,24].…”

Integrating a Health Literacy Lens into Nutrition Labelling Policy in Canada

“…The focus of the NVS on functional aspects of reading and numeracy in the context of a food label addresses the content and context specific domains of health literacy [18] and highlights its value for use in nutrition labelling research. Furthermore, the use of a nutrition label to assess health literacy is intuitively appealing, because nutrition labels are familiar across socio-demographics, and are an important part of health management for many chronic diseases [19,20].…”