Dataset Information

Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand.

ABSTRACT: BACKGROUND:Several front-of-pack (FOP) labels identify healthier options by comparing foods within product categories. Alternative approaches label healthier options by comparing across categories. Which approach is superior remains unknown. The objective of this study was to test the effect of a within-category versus across-category FOP lower calorie label on 1) the percentage of labeled products purchased, 2) several measures of calories purchased (total, per dollar and per serving), and 3) total spending. We also tested the moderating effects of hunger and mood on purchasing patterns. METHODS:Using an online grocery store, we conducted a 3?×?3 crossover trial involving actual purchases with 146 participants randomly exposed to: 1) no labeling control; 2) within-category lower calorie labels, and; 3) across-category lower calorie labels. We labeled the 20% of products with the lowest calories per serving within or across categories. Purchases were compared using a fixed effects regression on first-differenced outcomes. RESULTS:Relative to the control condition, there was a 3 percentage point increase (p?=?0.01) in labelled products purchased in the within-category arm and a non-significant decrease of 1 percentage point (p?=?0.711) in the across-category arm. There was no significant difference in the proportion of labeled products purchased between the two labelling conditions. Neither strategy resulted in reductions in any measure of calories purchased or in total spending. When limited to beverages, there was a 398?cal reduction (p?=?0.01) in the within-category arm and a 438?cal reduction (p?

SUBMITTER: Finkelstein EA

PROVIDER: S-EPMC7068974 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand.

Finkelstein Eric Andrew EA Ang Felicia Jia Ler FJL Doble Brett B

BMC public health 20200312 1

<h4>Background</h4>Several front-of-pack (FOP) labels identify healthier options by comparing foods within product categories. Alternative approaches label healthier options by comparing across categories. Which approach is superior remains unknown. The objective of this study was to test the effect of a within-category versus across-category FOP lower calorie label on 1) the percentage of labeled products purchased, 2) several measures of calories purchased (total, per dollar and per serving), ...[more]

PMID: 32164634

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Project description:indicator front-of-package nutrition labelling schemes are gaining momentum. In Europe, an example of such a scheme is Nutri-Score, which was first introduced in France. Supported by additional research, the scheme has the potential to expand into other countries. Such a scenario opens a series of questions related to the use of Nutri-Score in the territories with pre-existing food labelling schemes. A key question is whether different nutrition labelling schemes would provide conflicting information for consumers when applied to same foods. The goal of our study was, therefore, to evaluate the alignment of different front-of-package nutrition labelling schemes. The study was conducted using cross-sectional data on the composition of selected categories of prepacked foods with high penetration nutrition/health claims and symbols in the Slovenian food supply. We evaluated a variety of existing front-of-package nutrition labelling schemes: three interpretive nutrition rating systems (Nutri-Score, Health Star Rating (HSR), Traffic light system), four health symbols (Protective Food symbol, Choices, Finnish heart, and Keyhole symbol), and also three nutrient profile models developed for other purposes (Office of Communications (United Kingdom, Ofcom), World Health Organization Regional office for Europe (WHOE) and Food Standards Australia New Zealand (FSANZ)). Overall, our results indicate that interpretive nutrition rating systems (i.e., Nutri-Score) are mostly less strict than the nutrient profiles of tested health symbols. A risk of conflicting information would happen in a scenario where food is eligible to carry a health symbol, but is at the same time rated to have lower nutritional quality by an accompanying interpretive nutrition rating system. When Protective Food symbol and Nutri-Score are used together, this would occur for 5% of foods in our sample. To avoid such risks, schemes for health symbols could be adapted to be stricter than interpretive nutrition rating systems used in the same territory/market, but such adaptations are challenging and should be well planned. While our study showed that, in most cases, Nutri-Score is a less strict model than tested health symbols, the rating-system approach might offer useful support and incentive for food producers towards gradual food reformulation.

Project description:BACKGROUND:Front-of-pack (FOP) nutrition warning labels to identify potentially harmful foods/beverages have recently been considered in Singapore. The objective of this study was to pilot test two promising FOP warning labels intended to reduce purchases of products high in sugar to determine whether a full scale trial testing one or both these labels using actual purchases is warranted. METHODS:Five hundred twelve participants ?21?years old and residing in Singapore completed all study elements online via the NUSMart Online Grocery Store study website. The study was designed as a Randomized Controlled Trial (RCT) where consumers were randomized and asked to hypothetically shop in one of three versions of an online grocery store; 1) no FOP label (control), 2) a graphical high-in-sugar label shaped like a stop sign, or 3) a text-based warning label. The proportion of labelled products purchased (primary outcome) and all secondary measures of diet quality were calculated using participants' orders. Ordinary Least Squares (OLS) regression was used to compare purchasing behavior across the three study arms. RESULTS:The proportion of high-in-sugar products selected (i.e., those targeted for labelling) was largest in the no label control arm at 20%. The proportion was a non-statistically significant 2 percentage points lower (P?=?0.146) for the high-in-sugar stop-sign label arm and 4 percentage points lower (P?<?0.05) in the warning label with deterrent text arm. We could not reject the hypothesis of equal effectiveness of the two warning labels (P?=?0.231). CONCLUSIONS:Results suggest that the two health warning labels have potential to reduce demand for high-in-sugar products in Singapore. Future studies should test the influence of these labels using actual purchases in efforts to identify whether either labelling strategy should be considered for adoption in the local setting. TRIAL REGISTRATION:The American Economic Association's registry for randomized controlled trials; AEARCTR-0003800 . Registered 18 January 2019.

Dataset Information

Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand.

Publications

Randomized trial evaluating the effectiveness of within versus across-category front-of-package lower-calorie labelling on food demand.

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