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Nutrients. 2017 Nov 24;9(12). pii: E1284. doi: 10.3390/nu9121284.

Effects of Different Types of Front-of-Pack Labelling Information on the Healthiness of Food Purchases-A Randomised Controlled Trial.

Author information

1
The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia
2
The Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
3
Royal Prince Alfred Hospital, University of New South Wales, Sydney, NSW 2050, Australia
4
Department of Epidemiology and Biostatistics, Imperial College London, London SW7 2AZ, UK
5
Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA
6
National Heart Foundation of Australia, Melbourne, VIC 3000, Australia
7
Bupa, Brisbane, QLD 4001, Australia
8
National Institute for Health Innovation, University of Auckland, Auckland 1010, New Zealand
9
School of Psychology and Speech Pathology, Curtin University, Bentley, WA 6102, Australia
10
School of Health and Social Development, Deakin University, Melbourne, VIC 3008, Australia

Abstract

BACKGROUND:

Front-of-pack nutrition labelling may support healthier packaged food purchases. Australia has adopted a novel Health Star Rating (HSR) system, but the legitimacy of this choice is unknown.

OBJECTIVE:

To define the effects of different formats of front-of-pack labelling on the healthiness of food purchases and consumer perceptions.

DESIGN:

Individuals were assigned at random to access one of four different formats of nutrition labelling-HSR, multiple traffic light labels (MTL), daily intake guides (DIG), recommendations/warnings (WARN)-or control (the nutrition information panel, NIP). Participants accessed nutrition information by using a smartphone application to scan the bar-codes of packaged foods, while shopping. The primary outcome was healthiness defined by the mean transformed nutrient profile score of packaged foods that were purchased over four weeks.

RESULTS:

The 1578 participants, mean age 38 years, 84% female recorded purchases of 148,727 evaluable food items. The mean healthiness of the purchases in the HSR group was non-inferior to MTL, DIG, or WARN (all p < 0.001 at 2% non-inferiority margin). When compared to the NIP control, there was no difference in the mean healthiness of purchases for HSR, MTL, or DIG (all p > 0.07), but WARN resulted in healthier packaged food purchases (mean difference 0.87; 95% confidence interval 0.03 to 1.72; p = 0.04). HSR was perceived by participants as more useful than DIG, and easier to understand than MTL or DIG (all p < 0.05). Participants also reported the HSR to be easier to understand, and the HSR and MTL to be more useful, than NIP (all p < 0.03).

CONCLUSIONS:

These real-world data align with experimental findings and provide support for the policy choice of HSR. Recommendation/warning labels warrant further exploration, as they may be a stronger driver of healthy food purchases.

KEYWORDS:

food industry; food labelling; food purchases; policy; randomised trial

PMID:
29186803
PMCID:
PMC5748735
DOI:
10.3390/nu9121284
[Indexed for MEDLINE]
Free PMC Article

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