The Influence of Front-of-Package Nutrition Labeling on Consumer Behavior and Product Reformulation

Abstract

Countries worldwide have implemented mandatory or voluntary front-of-package nutrition labeling systems. We provide a narrative review of ( a) real-world evaluations of front-of-package nutrition labels that analyze objective sales data and ( b) studies that objectively assess product reformulation in response to a front-of-package nutrition label implementation. We argue that there is sufficient scientific evidence to recommend that governments implement mandatory front-of-package nutrition labeling systems to improve population health. We also present a conceptual framework to describe front-of-package label influence and provide recommendations for the optimal label design, emphasizing that labeling systems should be highly visible and salient, be simple and easy to understand, leverage automatic associations, and integrate informational and emotional messaging. The existing research suggests that Guideline Daily Amount labels should be avoided and that the Health Star Rating and Nutri-Score systems are promising but that systems with warning labels like the one in Chile are likely to produce the largest public health benefits. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

The Nutritional Profile and On-Pack Marketing of Toddler-Specific Food Products Launched in Australia between 1996 and 2020

“…This may be partly explained by the fact that the predominant type of snack food was fruit-based cereal bars, and some reformulation over time may have occurred. The small changes in nutrient compositions seen may align with product reformulation within this retail market [ 41 , 42 , 43 , 44 ], as snacks were seen to have lower median sodium, sugar, and carbohydrate levels at T3 as compared to T2, with sugar increasing at T4. Global research over various time periods reports toddler foods to be high in sugar and/or sodium [ 45 , 46 , 47 , 48 , 49 ].…”

The impact of pictorial health warnings on purchases of sugary drinks for children: A randomized controlled trial

“…Study predictions came from health behavior theory [ 24 – 27 ], the Tobacco Warnings Model [ 28 ] (an empirical model of how pictorial cigarette warnings exert effects on behavior), as well as prior research on sugary drink warnings [ 10 , 29 , 30 ] and pictorial tobacco warnings [ 13 , 28 , 31 ]. We predicted that parents randomized to pictorial health warnings would be less likely to purchase a sugary drink for their child and would purchase fewer calories from sugary drinks, compared to parents randomized to exposure to a control label.…”

Pandemic-related financial hardship and disparities in sugar-sweetened beverage consumption and purchasing among San Francisco Bay Area residents during COVID-19

“…Further, to reduce diet-related health inequities (in and out of pandemic circumstances), we should eliminate targeted marketing of SSBs to low-income populations and to children, as other countries have already done ( Taillie et al, 2020 ). Additional interventions that address commercial determinants of health, such as front-of-package labeling, may further reduce disparities in SSB consumption ( Gupta et al, 2021 , Roberto et al, 2021 ).…”