Sugar-Sweetened Beverage Health Warnings and Purchases: A Randomized Controlled Trial

Grummon, Anna H.; Taillie, Lindsey Smith; Golden, Shelley D.; Hall, Marissa G.; Ranney, Leah M.; Brewer, Noel T.

doi:10.1016/j.amepre.2019.06.019

Cited by 50 publications

(95 citation statements)

References 42 publications

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“…Recent experimental studies in Latin American populations have found that the style of FOP warning labels used in Chile is easier to understand and more likely to discourage consumption than other types of FOP labels, such as the GDAs or traffic-light labels [66][67][68]. In addition, a recent US-based randomized experiment found that nutrient-based FOP warning labels reduced SSB purchases by 31 calories per interaction, or 22% [69], which is similar to the effect observed in this study.…”

Section: Discussionsupporting

confidence: 83%

An evaluation of Chile’s Law of Food Labeling and Advertising on sugar-sweetened beverage purchases from 2015 to 2017: A before-and-after study

et al. 2020

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Background Chile's Law of Food Labeling and Advertising, implemented in 2016, was the first national regulation to jointly mandate front-of-package warning labels, restrict child-directed marketing, and ban sales in schools of all foods and beverages containing added sugars, sodium, or saturated fats that exceed set nutrient or calorie thresholds. The objective of this study is to evaluate the impact of this package of policies on household beverage purchases. Method and findings In this observational study, monthly longitudinal data on packaged beverage purchases were collected from urban-dwelling households (n = 2,383) participating in the Kantar Word-Panel Chile Survey from January 1, 2015, to December 31, 2017. Beverage purchases were linked to nutritional information at the product level, reviewed by a team of nutritionists, and categorized as "high-in" or "not high-in" according to whether they contained high levels of nutrients of concern (i.e., sugars, sodium, saturated fat, or energy) according to Chilean nutrient thresholds and were thus subject to the law's warning label, marketing restriction, and school sales ban policies. The majority of high-in beverages were categorized as such because of high sugar content. We used fixed-effects models to compare the observed volume as well as calorie and sugar content of postregulation beverage purchases to a counterfactual based on preregulation trends, overall and by household-head educational attainment. Of households included in the study, 37% of household heads had low education (less than high school), 40% had medium education (graduated high school), and 23% had high education (graduated college), with the sample becoming more educated over the study period. Compared to the counterfactual, the volume of high-in beverage purchases decreased 22.8 mL/capita/day, postregulation (95% confidence interval [CI] −22.9 to −22.7;

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Section: Discussionsupporting

confidence: 83%

An evaluation of Chile’s Law of Food Labeling and Advertising on sugar-sweetened beverage purchases from 2015 to 2017: A before-and-after study

et al. 2020

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“…As in previous labeling studies [ 25 ], a barcode was selected as the control label because it controls for the effect of putting a label on the front of a package (e.g., size, placement, obscuring branding), while also allowing all participants to respond to questions about a label.…”

Section: Methodsmentioning

confidence: 99%

Designing an Effective Front-of-Package Warning Label for Food and Drinks High in Added Sugar, Sodium, or Saturated Fat in Colombia: An Online Experiment

Taillie¹,

Hall²,

Gómez

et al. 2020

Nutrients

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Policies to require warnings on the front of food and drinks high in nutrients of concern (e.g., added sugar, sodium, or saturated fat) are becoming increasingly common as an obesity prevention strategy. Colombia, a country with growing prevalence of obesity, is considering implementing a similar policy. The objective of this study was to assess perceptions and reactions to different warning designs. We conducted a randomized experiment in an online panel of adults age > 18y (n = 1997). Participants were randomized to view one of four labels: a control label (barcode), an octagon warning, a circle warning, and a triangle warning. Participants viewed their randomly assigned label on a series of products and answered questions (continuous outcomes ranged from 1–4). Compared to the control, all warnings led to higher perceived message effectiveness (increase in mean from 1.79 in the control to 2.59–2.65 in the warning conditions, p < 0.001), a higher percentage of participants who correctly identified products high in nutrients of concern (from 48% in the control condition to 84–89% in the warning conditions, p < 0.001), and reduced intentions to purchases these products (decrease in mean from 2.59 to 1.99–2.01 in the warning conditions, p < 0.001). Relative to the control, warnings performed similarly across education levels, suggesting this policy would be equitable in Colombia. Looking at differences by warning type, the pattern of results suggested that the octagon warnings performed best. After viewing all label types, 49% of participants selected the octagon warning as the one that most discouraged them from consuming products high in nutrients of concern, while 21% and 27% selected the circle and triangle warning. Colombian policymakers should consider the octagon warning as part of a front-of-package labeling policy to help consumers identify and reduce consumption of foods and drinks high in nutrients of concern.

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“…Nutrition warnings that stated that a product was high or low in a key nutrient, such as sugar, sodium, or total fat influenced adults to avoid products with excessive amounts of these nutrients [73]. Warning labels that expressed general health consequences of excess sugar intake led adults to choose a beverage with less sugar compared to control labels [69]. Lima et al [39] investigated the impact of traffic light labels and nutrition warnings on drink choices of both children and adults.…”

Section: Labelmentioning

confidence: 99%

That’s My Cue to Eat: A Systematic Review of the Persuasiveness of Front-of-Pack Cues on Food Packages for Children vs. Adults

et al. 2020

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Packaging is increasingly recognized as an essential component of any marketing strategy. Visual and informational front-of-pack cues constitute salient elements of the environment that may influence what and how much someone eats. Considering their overwhelming presence on packaging of non-core foods, front-of-pack cues may contribute to the growing rates of overweight and obesity in children and adults. We conducted a systematic review to summarize the evidence concerning the impact of front-of-pack cues on choices and eating behaviors. Four electronic databases were searched for experimental studies (2009–present). This resulted in the inclusion of 57 studies (in 43 articles). We identified studies on children (3–12 years) and adults (≥ 18 years), but no studies on adolescents (12–18 years). The results suggest that children and adults are susceptible to packaging cues, with most evidence supporting the impact of visual cues. More specifically, children more often choose products with a licensed endorser and eat more from packages portraying the product with an exaggerated portion size. Adults’ eating behaviors are influenced by a range of other visual cues, mainly, package size and shape, and less so by informational cues such as labels.

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Sugar-Sweetened Beverage Health Warnings and Purchases: A Randomized Controlled Trial

Cited by 50 publications

References 42 publications

An evaluation of Chile’s Law of Food Labeling and Advertising on sugar-sweetened beverage purchases from 2015 to 2017: A before-and-after study

An evaluation of Chile’s Law of Food Labeling and Advertising on sugar-sweetened beverage purchases from 2015 to 2017: A before-and-after study

Designing an Effective Front-of-Package Warning Label for Food and Drinks High in Added Sugar, Sodium, or Saturated Fat in Colombia: An Online Experiment

That’s My Cue to Eat: A Systematic Review of the Persuasiveness of Front-of-Pack Cues on Food Packages for Children vs. Adults

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