Front-of-pack symbols are not a reliable indicator of products with healthier nutrient profiles

Emrich, Teri E.; Qi, Ying; Cohen, Joanna E.; Lou, Wendy; L'Abbe, Mary L.

doi:10.1016/j.appet.2014.09.017

Cited by 28 publications

(28 citation statements)

References 15 publications

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“…A survey of health symbols in Canada found few nutritional differences between foods carrying health symbols and those that do not. 22 Conversely, a survey in North Dakota revealed that 49% of foods carried a health-related claim, and of these 48% had ⩾20% saturated fat, sodium and/or sugar. This increased to 73% when examining the nutrient levels of foods carrying nutrient content claims but was much lower (9%) for health claims.…”

Section: Introductionmentioning

confidence: 99%

“…This increased to 73% when examining the nutrient levels of foods carrying nutrient content claims but was much lower (9%) for health claims. 23 However, these studies all sampled foods differently, for example, randomly selecting foods through a retailer's website, 21 sampling all foods within multiple stores in a single city 23 or sampling foods from the largest retailers, 22 making comparisons between studies problematic. This study involved sampling products from a number of European countries in order to investigate inter-country differences in the use of claims on food products, on a comparable basis.…”

Section: Introductionmentioning

confidence: 99%

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The nutritional quality of foods carrying health-related claims in Germany, The Netherlands, Spain, Slovenia and the United Kingdom

et al. 2016

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Backgroung/Objectives:Compares the nutritional quality of pre-packaged foods carrying health-related claims with foods that do not carry health-related claims.Subject/Methods:Cross-sectional survey of pre-packaged foods available in Germany, The Netherlands, Spain, Slovenia and the United Kingdom in 2013. A total of 2034 foods were randomly sampled from three food store types (a supermarket, a neighbourhood store and a discounter). Nutritional information was taken from nutrient declarations present on food labels and assessed through a comparison of mean levels, regression analyses and the application of a nutrient profile model currently used to regulate health claims in Australia and New Zealand (Food Standards Australia New Zealand's Nutrient Profiling Scoring Criterion, FSANZ NPSC).Results:Foods carrying health claims had, on average, lower levels, per 100 g, of the following nutrients, energy—29.3 kcal (P<0.05), protein—1.2 g (P<0.01), total sugars—3.1 g (P<0.05), saturated fat—2.4 g (P<0.001), and sodium—842 mg (P<0.001), and higher levels of fibre—0.8 g (P<0.001). A similar pattern was observed for foods carrying nutrition claims. Forty-three percent (confidence interval (CI) 41%, 45%) of foods passed the FSANZ NPSC, with foods carrying health claims more likely to pass (70%, CI 64%, 76%) than foods carrying nutrition claims (61%, CI 57%, 66%) or foods that did not carry either type of claim (36%, CI 34%, 38%).Conclusions:Foods carrying health-related claims have marginally better nutrition profiles than those that do not carry claims; these differences would be increased if the FSANZ NPSC was used to regulate health-related claims. It is unclear whether these relatively small differences have significant impacts on health.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The nutritional quality of foods carrying health-related claims in Germany, The Netherlands, Spain, Slovenia and the United Kingdom

et al. 2016

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“…Prior studies have highlighted the use of nutrition marketing claims and FOP in certain product categories, key among them prepared meals (Colby and others, ; Emrich and others ). In comparison, other studies have suggested breakfast cereals have improved nutritional quality in recent years, with labeling innovations reinforcing this trend (see, for example, Chun Yu Louie and others ; Devi and others ).…”

Section: Methodsmentioning

confidence: 99%

“…However, to date, there have been very few large‐scale examinations of the relationship between FOP nutrition claims and overall objective nutrition quality (Townsend ; Andrews and others ). A notable exception in Canada is Emrich and others (). Also, Lichtenstein and others () use NHANES data to suggest a potential improvement in diet quality for consumers who more frequently selected foods which met one particular FOP standard—the American Heart Associations’ Heart Check .…”

Section: Introductionmentioning

confidence: 99%

Are Front of Pack Claims Indicators of Nutrition Quality? Evidence from 2 Product Categories

Schaefer¹,

Hooker

Stanton

2015

Journal of Food Science

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American grocery shoppers face an array of front of pack (FOP) nutrition and health claims when making food selections. Such systems have been categorized as summary or nutrient specific. Either type should help consumers make judgments about the nutrition quality of a product. This research tests if the type or quantity of FOP claims are indeed good indicators of objective nutrition quality. Claim and nutrition information from more than 2200 breakfast cereals and prepared meals launched between 2006 and 2010 were analyzed using binary and multinomial logistic regression models. Results suggest that no type or number of front of pack claims could distinguish "healthy" foods. However, some types and frequencies of FOP claims were significant predictors of higher or lower levels of certain key nutrients. Given the complex and crowded label environment in which these FOP claims reside, one may be concerned that such cues are not closely related to objective measures of nutrition quality.

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“…However, previous research indicates that voluntary summary indicator systems displayed on pre-packaged food items may not always align with a product's nutritional quality (Emrich et al, 2015, Roberto et al, 2012). …”

Section: Introductionmentioning

confidence: 98%

A voluntary nutrition labeling program in restaurants: Consumer awareness, use of nutrition information, and food selection

White

Lillico

Vanderlee

et al. 2016

Preventive Medicine Reports

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Health Check (HC) was a voluntary nutrition labeling program developed by the Heart and Stroke Foundation of Canada as a guide to help consumers choose healthy foods. Items meeting nutrient criteria were identified with a HC symbol. This study examined the impact of the program on differences in consumer awareness and use of nutritional information in restaurants. Exit surveys were conducted with 1126 patrons outside four HC and four comparison restaurants in Ontario, Canada (2013). Surveys assessed participant noticing of nutrition information, influence of nutrition information on menu selection, and nutrient intake. Significantly more patrons at HC restaurants noticed nutrition information than at comparison restaurants (34.2% vs. 28.1%; OR = 1.39; p = 0.019); however, only 5% of HC restaurant patrons recalled seeing the HC symbol. HC restaurant patrons were more likely to say that their order was influenced by nutrition information (10.9% vs. 4.5%; OR = 2.96, p < 0.001); and consumed less saturated fat and carbohydrates, and more protein and fibre (p < 0.05). Approximately 15% of HC restaurant patrons ordered HC approved items; however, only 1% ordered a HC item and mentioned seeing the symbol in the restaurant in an unprompted recall task, and only 4% ordered a HC item and reported seeing the symbol on the item when asked directly. The HC program was associated with greater levels of noticing and influence of nutrition information, and more favourable nutrient intake; however, awareness of the HC program was very low and differences most likely reflect the type of restaurants that “self-selected” into the program.

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Front-of-pack symbols are not a reliable indicator of products with healthier nutrient profiles

Cited by 28 publications

References 15 publications

The nutritional quality of foods carrying health-related claims in Germany, The Netherlands, Spain, Slovenia and the United Kingdom

The nutritional quality of foods carrying health-related claims in Germany, The Netherlands, Spain, Slovenia and the United Kingdom

Are Front of Pack Claims Indicators of Nutrition Quality? Evidence from 2 Product Categories

A voluntary nutrition labeling program in restaurants: Consumer awareness, use of nutrition information, and food selection

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