Objective Understanding of Front-of-Package Nutrition Labels: An International Comparative Experimental Study across 12 Countries
Abstract
:1. Introduction
2. Methods
2.1. Participants
2.2. Design and Stimuli
2.3. Procedure
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Argentina | Australia | Bulgaria | Canada | Denmark | France | Germany | Mexico | Singapore | Spain | USA | UK | Total | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | |
Sex | |||||||||||||
Men | 496 (49.55) | 500 (50.00) | 508 (50.15) | 500 (50.00) | 500 (50.00) | 500 (50.00) | 500 (50.00) | 501 (50.05) | 500 (50.00) | 500 (50.00) | 500 (50.00) | 500 (50.00) | 6005 (49.98) |
Women | 505 (50.45) | 500 (50.00) | 505 (49.85) | 500 (50.00) | 500 (50.00) | 500 (50.00) | 500 (50.00) | 500 (49.95) | 500 (50.00) | 500 (50.00) | 500 (50.00) | 500 (50.00) | 6010 (50.02) |
Age, years | |||||||||||||
18–30 | 336 (33.57) | 331 (33.10) | 359 (35.44) | 332 (33.20) | 328 (32.80) | 333 (33.30) | 340 (34.00) | 340 (33.97) | 340 (34.00) | 339 (33.90) | 332 (33.20) | 332 (33.20) | 4042 (33.64) |
31–50 | 332 (33.17) | 335 (33.50) | 379 (37.41) | 334 (33.40) | 333 (33.30) | 333 (33.30) | 330 (33.00) | 335 (33.47) | 337 (33.70) | 331 (33.10) | 334 (33.40) | 334 (33.40) | 4047 (33.68) |
>50 | 333 (33.27) | 334 (33.40) | 275 (27.15) | 334 (33.40) | 339 (33.90) | 334 (33.40) | 330 (33.00) | 326 (32.57) | 323 (32.30) | 330 (33.00) | 334 (33.40) | 334 (33.40) | 3926 (32.68) |
Educational level | |||||||||||||
Primary education | 14 (1.40) | 9 (0.90) | 6 (0.59) | 26 (2.60) | 94 (9.40) | 17 (1.70) | 97 (9.70) | 2 (0.20) | 6 (0.60) | 21 (2.10) | 136 (13.60) | 7 (0.70) | 435 (3.62) |
Secondary education | 256 (25.57) | 263 (26.30) | 142 (14.02) | 263 (26.30) | 172 (17.20) | 183 (18.30) | 382 (38.20) | 102 (10.19) | 123 (12.30) | 316 (31.60) | 232 (23.20) | 381 (38.10) | 2815 (23.43) |
Trade certificate | 244 (24.38) | 196 (19.60) | 252 (24.88) | 203 (20.30) | 391 (39.10) | 266 (26.60) | 241 (24.10) | 145 (14.49) | 204 (20.40) | 166 (16.60) | 115 (11.50) | 144 (14.40) | 2567 (21.36) |
University undergraduate degree | 372 (37.16) | 389 (38.90) | 262 (25.86) | 358 (35.80) | 210 (21.00) | 334 (33.40) | 129 (12.90) | 544 (54.35) | 494 (49.40) | 282 (28.20) | 349 (34.90) | 343 (34.30) | 4066 (33.84) |
University postgraduate degree | 115 (11.49) | 143 (14.30) | 351 (34.65) | 150 (15.00) | 133 (13.30) | 200 (20.00) | 151 (15.10) | 208 (20.78) | 173 (17.30) | 215 (21.50) | 168 (16.80) | 125 (12.50) | 2132 (17.74) |
Level of income | |||||||||||||
High | 330 (32.97) | 335 (33.50) | 370 (36.53) | 325 (32.50) | 320 (32.00) | 334 (33.40) | 327 (32.70) | 331 (33.07) | 324 (32.40) | 330 (33.00) | 325 (32.50) | 335 (33.50) | 3986 (33.18) |
Medium | 333 (33.27) | 334 (33.40) | 359 (35.44) | 335 (33.50) | 340 (34.00) | 333 (33.30) | 333 (33.30) | 330 (32.97) | 336 (33.60) | 330 (33.00) | 335 (33.50) | 335 (33.50) | 4033 (33.57) |
Low | 338 (33.77) | 331 (33.10) | 284 (28.04) | 340 (34.00) | 340 (34.00) | 333 (33.30) | 340 (34.00) | 340 (33.97) | 340 (34.00) | 340 (34.00) | 340 (34.00) | 330 (33.00) | 3996 (33.26) |
Responsible for grocery shopping | |||||||||||||
Yes | 809 (80.82) | 719 (71.90) | 599 (59.13) | 750 (75.00) | 690 (69.00) | 863 (86.30) | 769 (76.90) | 819 (81.82) | 638 (63.80) | 747 (74.70) | 793 (79.30) | 750 (75.0) | 8946 (74.46) |
No | 45 (4.50) | 74 (7.40) | 64 (6.32) | 45 (4.50) | 55 (5.50) | 21 (2.10) | 31 (3.10) | 34 (3.40) | 81 (8.10) | 35 (3.50) | 56 (5.60) | 35 (3.50) | 576 (4.79) |
Share job equally | 147 (14.69) | 207 (20.70) | 350 (34.55) | 205 (20.50) | 255 (25.50) | 116 (11.60) | 200 (20.00) | 148 (14.79) | 281 (28.10) | 218 (21.80) | 151 (15.10) | 215 (21.50) | 2493 (20.75) |
Self-estimated diet quality | |||||||||||||
I eat a very unhealthy diet | 17 (1.70) | 4 (0.40) | 48 (4.74) | 19 (1.90) | 12 (1.20) | 20 (2.00) | 34 (3.40) | 16 (1.60) | 11 (1.10) | 11 (1.10) | 28 (2.80) | 11 (1.10) | 231 (1.92) |
I eat a mostly unhealthy diet | 227 (22.68) | 159 (15.90) | 609 (60.12) | 171 (17.10) | 199 (19.90) | 182 (18.20) | 202 (20.20) | 274 (27.37) | 220 (22.00) | 162 (16.20) | 217 (21.70) | 211 (21.10) | 2833 (23.58) |
I eat a mostly healthy diet | 603 (60.24) | 763 (76.30) | 341 (33.66) | 729 (72.90) | 727 (72.70) | 660 (66.00) | 677 (67.70) | 547 (54.65) | 691 (69.10) | 711 (71.10) | 638 (63.80) | 715 (71.50) | 7802 (64.94) |
I eat a very healthy diet | 154 (15.38) | 74 (7.40) | 15 (1.48) | 81 (8.10) | 62 (6.20) | 138 (13.80) | 87 (8.70) | 164 (16.38) | 78 (7.80) | 116 (11.60) | 117 (11.70) | 63 (6.30) | 1149 (9.56) |
Nutrition knowledge | |||||||||||||
I do not know anything about nutrition | 18 (1.80) | 7 (0.70) | 9 (0.89) | 10 (1.00) | 10 (1.00) | 51 (5.10) | 15 (1.50) | 14 (1.40) | 5 (0.50) | 26 (2.60) | 16 (1.60) | 17 (1.70) | 198 (1.65) |
I am not very knowledgeable about nutrition | 244 (24.38) | 174 (17.40) | 210 (20.73) | 141 (14.10) | 166 (16.60) | 408 (40.80) | 193 (19.30) | 289 (28.87) | 198 (19.80) | 287 (28.70) | 147 (14.70) | 235 (23.50) | 2692 (22.41) |
I am somewhat knowledgeable about nutrition | 557 (55.64) | 695 (69.50) | 627 (61.9) | 658 (65.80) | 638 (63.80) | 380 (38.00) | 617 (61.70) | 554 (55.34) | 664 (66.40) | 609 (60.90) | 641 (64.10) | 664 (66.40) | 7304 (60.79) |
I am very knowledgeable about nutrition | 182 (18.18) | 124 (12.40) | 167 (16.49) | 191 (19.10) | 186 (18.60) | 161 (16.10) | 175 (17.50) | 144 (14.39) | 133 (13.30) | 78 (7.80) | 196 (19.60) | 84 (8.40) | 1821 (15.16) |
Did you see the FoP label during the survey? | |||||||||||||
No | 165 (16.48) | 168 (16.80) | 311 (30.70) | 242 (24.20) | 351 (35.10) | 321 (32.10) | 306 (30.60) | 176 (17.58) | 246 (24.60) | 275 (27.50) | 240 (24.00) | 256 (25.60) | 3057 (25.44) |
Unsure | 109 (10.89) | 47 (4.70) | 139 (13.72) | 83 (8.30) | 75 (7.50) | 75 (7.50) | 140 (14.00) | 94 (9.39) | 129 (12.90) | 150 (15.00) | 77 (7.70) | 90 (9.00) | 1208 (10.05) |
Yes | 727 (72.63) | 508 (50.80) | 563 (55.58) | 675 (67.50) | 574 (57.40) | 604 (60.40) | 554 (55.40) | 731 (73.03) | 625 (62.50) | 575 (57.50) | 683 (68.30) | 654 (65.40) | 7473 (62.20) |
Participants who recalled seeing the FoPL they were exposed to | |||||||||||||
HSR | 135 (67.50) | 112 (77.78) | 85 (42.08) | 127 (63.50) | 105 (52.50) | 103 (51.50) | 90 (45.00) | 133 (66.17) | 109 (54.50) | 82 (41.00) | 137 (68.50) | 109 (54.50) | 1327 (56.54) |
MTL | 161 (80.50) | 102 (70.34) | 120 (59.11) | 145 (72.50) | 125 (62.50) | 138 (69.00) | 128 (64.00) | 170 (85.00) | 147 (73.50) | 140 (70.00) | 151 (75.50) | 160 (80.00) | 1687 (71.85) |
Nutri-Score | 142 (71.00) | 99 (68.75) | 152 (75.25) | 144 (72.00) | 131 (65.50) | 130 (65.00) | 136 (68.00) | 152 (76.00) | 125 (62.50) | 107 (53.50) | 155 (77.50) | 138 (69.00) | 1611 (68.67) |
RIs | 163 (81.09) | 120 (82.76) | 112 (55.17) | 149 (74.87) | 133 (66.50) | 131 (65.50) | 128 (64.00) | 165 (82.50) | 152 (76.00) | 155 (77.50) | 150 (75.00) | 153 (76.50) | 1711 (72.87) |
Warning symbol | 126 (63.00) | 75 (51.72) | 94 (46.31) | 110 (54.73) | 80 (40.00) | 102 (51.00) | 72 (36.00) | 111 (55.50) | 92 (46.00) | 91 (45.50) | 90 (45.00) | 94 (47.00) | 1137 (48.40) |
Countries | n | HSR | MTL | Nutri-Score | Warning Symbol | ||||
---|---|---|---|---|---|---|---|---|---|
OR [95% CI] | p | OR [95% CI] | p | OR [95% CI] | p | OR [95% CI] | p | ||
All countries | 12,015 | 1.37 [1.23–1.53] | <0.0001 | 1.77 [1.59–1.98] | <0.0001 | 3.07 [2.75–3.43] | <0.0001 | 1.28 [1.15–1.43] | <0.0001 |
Argentina | 1001 | 1.14 [0.79–1.66] | 0.7 | 1.22 [0.84–1.78] | 0.6 | 2.14 [1.48–3.10] | 0.001 | 0.98 [0.67–1.43] | 1.0 |
Australia | 1000 | 1.86 [1.27–2.74] | 0.02 | 1.52 [1.03–2.24] | 0.2 | 4.15 [2.82–6.11] | <0.0001 | 1.41 [0.95–2.08] | 0.3 |
Bulgaria | 1013 | 1.97 [1.31–2.97] | 0.01 | 1.12 [0.74–1.67] | 0.8 | 2.34 [1.55–3.53] | 0.001 | 1.28 [0.85–1.91] | 0.6 |
Canada | 1000 | 1.49 [1.02–2.17] | 0.2 | 1.71 [1.17–2.49] | 0.05 | 3.30 [2.27–4.80] | <0.0001 | 1.35 [0.92–1.97] | 0.4 |
Denmark | 1000 | 1.09 [0.75–1.60] | 0.8 | 1.65 [1.13–2.40] | 0.09 | 2.46 [1.69–3.58] | <0.0001 | 1.02 [0.70–1.49] | 1.0 |
France | 1000 | 1.53 [1.03–2.27] | 0.2 | 2.42 [1.63–3.57] | 0.0002 | 4.29 [2.90–6.35] | <0.0001 | 1.51 [1.02–2.24] | 0.2 |
Germany | 1000 | 1.20 [0.80–1.80] | 0.6 | 2.15 [1.44–3.21] | 0.003 | 2.72 [1.83–4.05] | <0.0001 | 1.10 [0.73–1.65] | 0.8 |
Mexico | 1001 | 1.30 [0.89–1.90] | 0.5 | 2.61 [1.78–3.81] | <0.0001 | 2.67 [1.83–3.90] | <0.0001 | 1.63 [1.11–2.39] | 0.1 |
Singapore | 1000 | 1.99 [1.35–2.93] | 0.007 | 2.06 [1.40–3.03] | 0.004 | 4.45 [3.02–6.56] | <0.0001 | 2.04 [1.39–3.00] | 0.005 |
Spain | 1000 | 0.81 [0.55–1.20] | 0.6 | 1.77 [1.20–2.61] | 0.04 | 3.00 [2.04–4.41] | <0.0001 | 1.17 [0.79–1.72] | 0.7 |
USA | 1000 | 1.28 [0.87–1.87] | 0.5 | 1.96 [1.34–2.86] | 0.007 | 3.10 [2.12–4.53] | <0.0001 | 1.06 [0.72–1.56] | 0.9 |
UK | 1000 | 1.32 [0.89–1.95] | 0.5 | 1.97 [1.34–2.89] | 0.008 | 4.21 [2.86–6.20] | <0.0001 | 1.25 [0.85–1.85] | 0.6 |
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Egnell, M.; Talati, Z.; Hercberg, S.; Pettigrew, S.; Julia, C. Objective Understanding of Front-of-Package Nutrition Labels: An International Comparative Experimental Study across 12 Countries. Nutrients 2018, 10, 1542. https://doi.org/10.3390/nu10101542
Egnell M, Talati Z, Hercberg S, Pettigrew S, Julia C. Objective Understanding of Front-of-Package Nutrition Labels: An International Comparative Experimental Study across 12 Countries. Nutrients. 2018; 10(10):1542. https://doi.org/10.3390/nu10101542
Chicago/Turabian StyleEgnell, Manon, Zenobia Talati, Serge Hercberg, Simone Pettigrew, and Chantal Julia. 2018. "Objective Understanding of Front-of-Package Nutrition Labels: An International Comparative Experimental Study across 12 Countries" Nutrients 10, no. 10: 1542. https://doi.org/10.3390/nu10101542