Nutrition-related claims lead parents to choose less healthy drinks for young children: a randomized trial in a virtual convenience store

Abstract

Background Consumption of sugar-sweetened beverages, including fruit drinks (i.e., fruit-flavored drinks containing added sugar), contributes to childhood obesity. Objectives We aimed to examine whether nutrition-related claims on fruit drinks influence purchasing among parents and lead to misperceptions of healthfulness. Methods We conducted an experiment in a virtual convenience store with 2218 parents of children ages 1–5. Parents were randomly assigned to view fruit drinks displaying one of three claims (“No artificial sweeteners,” “100% Vitamin C,” and “100% All Natural”) or no claim (i.e., control group). Parents selected among each of two drinks for their young child: 1) a fruit drink or 100% juice (primary outcome), and 2) a fruit drink or water. Results When choosing between a fruit drink and 100% juice, 45% of parents who viewed the fruit drink with the “No artificial sweeteners” claim, 51% who viewed the “100% Vitamin C” claim, and 54% who viewed the “100% All Natural” claim selected the fruit drink, compared with 32% in the no-claim control group (all P < 0.001). “No artificial sweeteners” (Cohen's d = 0.14, P < 0.05) and “100% All Natural” (d = 0.15, P < 0.05) claims increased the likelihood of parents choosing the fruit drink instead of water but “100% Vitamin C” did not (P = 0.059). All claims made parents more likely to incorrectly believe that the fruit drinks contained no added sugar and were 100% juice compared to the control (d ranged from 0.26–0.84, all P < 0.001), as assessed in a post-test survey. The impact of claims on selection of the fruit drink (versus 100% juice) did not vary by any of the moderators examined (e.g., race/ethnicity, income; all moderation P > 0.057). Conclusions Nutrition-related claims led parents to choose less healthy beverages for their children and misled them about the healthfulness of fruit drinks. Labeling regulations could mitigate misleading marketing of fruit drinks. Clinical Trial Registry: This trial was registered with ClinicalTrials.gov as NCT04381481.

Effect of Front-of-Package Information, Fruit Imagery, and High–Added Sugar Warning Labels on Parent Beverage Choices for Children

“…Claim and imagery removal had no knowledge or health perception effects combined or independently. While previous findings on whether fruit imagery impacts health perceptions are mixed, 13,44 our findings differ from previous studies that found that nutrient content claims, 15 100% vitamin C claims in particular, 18,44 increased perceptions that drinks were healthy and selection of high-added sugar beverages. These differences are likely due to product type (branded vs mock or unbranded products) and choices offered (many different beverages vs 1 other beverage).…”

“…9,11,12 Research has shown that this marketing misleads consumers. [13][14][15][16][17][18] In a 2022 study, 18 parents who viewed fruit drinks with claims were more likely to incorrectly believe that these products did not contain added sugar or were 100% juice. Correcting these misperceptions could enhance parents' knowledge and encourage healthier beverage purchases.…”

Efficacy of different front-of-package labeling systems in changing purchase intention and product healthfulness perception for food products in Argentina

“…However, while a nutrient claim might be truthful in terms of a specific nutrient (“0% trans-fat”), this study suggests that the presence of the claim boosts purchase intention and perceived healthfulness, for products that may have excess content of other critical nutrients such as sugars, saturated fats or sodium. This “halo effect” of nutrient claims has been demonstrated to lead consumers to overestimate the nutritional quality of food products ( 9 , 10 , 31 ), reduce the efficacy of FOP labels when claims refer to the same nutrient that is warned on the FOP label ( 32 ), ultimately inducing consumers to purchase products that are excessive in critical nutrients. This result underscores the importance of promoting strict regulations that prohibit the use of health or nutrition claims on products with excessive content of one or more critical nutrients, as has been regulated recently in Argentina ( 15 ) and implemented in other countries such as Australia, New Zealand ( 33 ) and Mexico ( 13 ), as well as the need for labeling policies and regulations to be more coherent with other policies aimed at promoting healthy diets.…”

When Will the FDA Do What Is in People’s Best Interests?

“…Here is an example of our current situation: "Nutrition-related claims led parents to choose less healthy beverages for their children and misled them about the healthfulness of fruit drinks. Labeling regulations could mitigate misleading marketing of fruit drinks" (Hall et al 2022).…”