Dataset Information

Appropriation of the Front-of-Pack Nutrition Label Nutri-Score across the French Population: Evolution of Awareness, Support, and Purchasing Behaviors between 2018 and 2019.

ABSTRACT: Since the implementation of the Nutri-Score on a voluntary basis in 2017 in France, very few studies have evaluated how the label was recognized and used by consumers. The goal of this study was to assess the evolution of awareness, support, and perceived impact on purchasing behaviors of the Nutri-Score in France. Between April 2018 and May 2019, a total of 4006 participants were recruited across three successive waves and answered questions regarding awareness of the Nutri-Score, support of the measure, and change of behavior following the implementation of the Nutri-Score via an online survey. Descriptive analyses to assess the evolution over time were performed, as well as logistic regression models to evaluate associations between the different outcomes and individual characteristics. From April 2018 to May 2019, the awareness of the Nutri-Score increased considerably, reaching 81.5% in May 2019. Since April 2018, a steady proportion of participants-9 out of 10-showed strong support toward the measure and a similar proportion, 87.2%, declared being in favor of making the Nutri-Score mandatory. The impact on purchasing behaviors appeared promising given the limited implementation of the label, with 42.9% of the participants reporting they modified their purchasing behaviors thanks to the measure. Multivariate analyses showed that the impact on purchasing behaviors of the Nutri-Score was greater over time, on younger populations and on frequent labeling readers. Our results suggested that the labeling system was well received and used by all socioeconomic groups, including subgroups who are more likely to have a lower-quality diet.

SUBMITTER: Sarda B

PROVIDER: S-EPMC7551644 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Appropriation of the Front-of-Pack Nutrition Label Nutri-Score across the French Population: Evolution of Awareness, Support, and Purchasing Behaviors between 2018 and 2019.

Sarda Barthélemy B Julia Chantal C Serry Anne-Juliette AJ Ducrot Pauline P

Nutrients 20200922 9

Since the implementation of the Nutri-Score on a voluntary basis in 2017 in France, very few studies have evaluated how the label was recognized and used by consumers. The goal of this study was to assess the evolution of awareness, support, and perceived impact on purchasing behaviors of the Nutri-Score in France. Between April 2018 and May 2019, a total of 4006 participants were recruited across three successive waves and answered questions regarding awareness of the Nutri-Score, support of th ...[more]

PMID: 32971744

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Project description:BackgroundThe Nutri-Score summary graded front-of-pack nutrition label has been identified as an efficient tool to increase the nutritional quality of pre-packed food purchases. However, no study has been conducted to investigate the effect of the Nutri-Score on the shopping cart composition, considering the type of foods. The present paper aims to investigate the effect of the Nutri-Score on the type of food purchases, in terms of the relative contribution of unpacked and pre-packed foods, or the processing degree of foods.MethodsBetween September 2016 and April 2017, three consecutive randomized controlled trials were conducted in three specific populations - students (N = 1866), low-income individuals (N = 336) and subjects suffering from cardiometabolic diseases (N = 1180) - to investigate the effect of the Nutri-Score on purchasing intentions compared to the Reference Intakes and no label. Using these combined data, the proportion of unpacked products in the shopping carts, as well as the distribution of products across food categories taking into account the degree of processing (NOVA classification) were assessed by trials arm.ResultsThe shopping carts of participants simulating purchases with the Nutri-Score affixed on pre-packed foods contained higher proportion of unpacked products - especially raw fruits and meats, i.e. with no FoPL -, compared to participants purchasing with no label (difference of 5.93 percentage points [3.88-7.99], p-value< 0.0001) or with the Reference Intakes (difference of 5.27[3.25-7.29], p-value< 0.0001). This higher proportion was partly explained by fewer purchases of pre-packed processed and ultra-processed products overall in the Nutri-Score group.ConclusionsThese findings provide new insights on the positive effect of the Nutri-Score, which appears to decrease purchases in processed products resulting in higher proportions of unprocessed and unpacked foods, in line with public health recommendations.

Project description:Front-of-pack nutrition labels (FoPLs) aim at increasing transparency and consumers' awareness of the nutritional composition of pre-packed food products in order to improve the nutritional quality of their food choices. Nevertheless, the legitimacy of the Nutri-Score - the FoPL officially adopted in France and several other European countries - is subject to both technical and political controversy, particularly in Italy. In this study, we investigated how and by whom the legitimacy of the Nutri-Score, recognized by several institutional authorities, could be deconstructed within a specific system of norms, values and beliefs among Italian stakeholders. A netnography completed with qualitative interviews with eight Italian and French nutrition and public health experts were carried out to highlight the dimensions (pragmatic, normative and cognitive) in which the Nutri-Score's legitimacy is being challenged among the stakeholders involved in FoPLs' implementation in Italy. The degree of influence and the position of these stakeholders on the debate around the Nutri-Score were assessed through the Stakeholder Theory (SHT), using their respective level of power, legitimacy and urgency. Furthermore, we compared the Italian and the French contexts on the issue. The direct implication of political parties and media outlets in framing the Italian debate around Nutri-Score as well as the high influence of corporate unions, led to a different political outcome than in France. Results also show that the deconstruction of the legitimacy of the Nutri-Score in Italy pertained mainly to its pragmatic dimension according to the Italian public health experts. Nevertheless, its two other dimensions (normative and cognitive) are also questioned by high-influence stakeholders. Due to the limited mobilization of scientific expertise over the issue, the debate in Italy stayed centered around the "attack" of the Nutri-Score to the Italian way of life, mixing up concepts such as Made in Italy products and the Mediterranean diet.

Project description:BackgroundTo date, no consensus has emerged on the most appropriate front-of-pack (FOP) nutrition label to help consumers in making informed choices. We aimed to compare the effectiveness of the label formats currently in use: nutrient-specific, graded and simple summary systems, in a large sample of adults.MethodsThe FOP label effectiveness was assessed by measuring the label acceptability and understanding among 13,578 participants of the NutriNet-Santé cohort study, representative of the French adult population. Participants were exposed to five conditions, including four FOP labels: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), 5-Color Nutrition Label (5-CNL), Green Tick (Tick), and a "no label" condition. Acceptability was evaluated by several indicators: attractiveness, liking and perceived cognitive workload. Objective understanding was assessed by the percentage of correct answers when ranking three products according to their nutritional quality. Five different product categories were tested: prepared fish dishes, pizzas, dairy products, breakfast cereals, and appetizers. Differences among the label effectiveness were compared with chi-square tests.ResultsThe 5-CNL was viewed as the easiest label to identify and as the one requiring the lowest amount of effort and time to understand. GDA was considered as the least easy to identify and to understand, despite being the most attractive and liked label. All FOP labels were found to be effective in ranking products according to their nutritional quality compared with the "no label" situation, although they showed differing levels of effectiveness (p<0.0001). Globally, the 5-CNL performed best, followed by MTL, GDA and Tick labels.ConclusionsThe graded 5-CNL label was considered as easy to identify, simple and rapid to understand; it performed well when comparing the products' nutritional quality. Therefore, it is likely to present advantages in real shopping situations where choices are usually made quickly.

Project description:BACKGROUND:Front-of-pack (FOP) nutrition labeling is a cost-effective strategy to help consumers make informed and healthier food choices. We aimed to investigate the effect of the FOP labels used in the Latin American region on consumers' shopping intentions when prompted to make their choices with specific nutrients-to-limit in mind among low- and middle-income Mexican adults (> 18 y). METHODS:In this experimental study of an online simulated shopping situation participants (n = 2194) were randomly assigned to one of three labeling conditions: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), or red Warning Labels (WL). Participants were required to view a video explaining how to correctly interpret the assigned label. Primary outcomes were the overall nutritional quality (estimated using the Nutrient Profiling Scoring Criterion [NPSC] and NPSC baseline score) and mean energy and nutrient content of purchases. Secondary outcomes included shopping time variables. We also evaluated the impact of the labels across food categories (ready-made foods, dairy beverages, non-dairy beverages, salty snacks, and breakfast cereals) and sociodemographic subgroups. RESULTS:The MTL and the WL led to a better overall nutritional quality of the shopping cart compared to the GDA (p < 0.05). According to the NPSC score, the WL led to a better nutritional quality across breakfast cereals and salty snacks compared to the GDA (p < 0.05); a similar effect was observed for the MTL among non-dairy beverages (p < 0.05). The MTL and the WL required shorter shopping times compared to GDA (p < 0.05). Across all labeling conditions, the nutritional quality of the shopping cart tended to be lower among those with low income, education and nutrition knowledge levels. CONCLUSION:WL and MTL may foster healthier food choices in a faster way among low- and middle-income groups in Mexico. To produce an equitable impact among consumers of all socioeconomic strata, efforts beyond simply the inclusion of a communication campaign on how to use and interpret FOP labels will be required. TRIAL REGISTRATION:clinicaltrials.gov. NCT04308408 Retrospectively registered March 16, 2020.

Dataset Information

Appropriation of the Front-of-Pack Nutrition Label Nutri-Score across the French Population: Evolution of Awareness, Support, and Purchasing Behaviors between 2018 and 2019.

Publications

Appropriation of the Front-of-Pack Nutrition Label Nutri-Score across the French Population: Evolution of Awareness, Support, and Purchasing Behaviors between 2018 and 2019.

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