Healthy or Not Healthy? A Mixed-Methods Approach to Evaluate Front-of-Pack Nutrition Labels as a Tool to Guide Consumers
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Ethical Considerations
2.3. Recruitment
2.3.1. Interview Participants: Qualitative Study
2.3.2. Survey Respondents: Quantitative Study
2.4. Procedure
2.4.1. Interviews: Qualitative Study
2.4.2. Surveys: Quantitative Study
2.5. Data Analysis
2.5.1. Interview Data: Qualitative Study
2.5.2. Survey Data: Quantitative Study
2.5.3. Integration of Data Sets
2.6. Trustworthiness, Validity and Reliability
3. Results
3.1. Study Sample Characteristics
3.1.1. Qualitative Study (Interview Participants)
3.1.2. Quantitative Study (Survey Respondents)
3.2. Qualitative Themes from the Interviews
3.2.1. Make it Clearer (Theme 1)
3.2.2. Make it Simpler (Theme 2)
“Whatever you do, you have to be consistent because consumers can’t see ‘live well, eat well’ for one company’s product [a local manufacturer’s logo], but then there are GDAs on all the multinationals’ products.”[PR21]
3.2.3. Make it Smarter (Theme 3)
“It is an enormous task to try and put a statement [on a package], a blanket statement that would fit 53 million people. But then I thought to myself—with algorithms and big data, it’s maybe not so far off anymore… Information interpreted for me, to help me to make better decisions.”[CN1]
“If your target is the poorly educated poor people, then technology is not the solution, because they can’t afford data… and the older generation, who didn’t grow up with that technology, get excluded.”[PR23]
3.2.4. Challenges to Effective Static (On-Pack) Food Labels
3.3. Quantitative Findings from the Consumer Survey
3.3.1. Selection and Creation of FOP Labels
3.3.2. Reliability of Survey Results
3.3.3. Performance of FOP Labels
3.4. Integration
- Synopsis of the label improvement suggestions made by participants in the qualitative phase of the study;
- A single illustrative quote for the theme (additional quotes are available in the Supplementary Materials);
- Application of qualitative insights to the consumer survey;
- A synopsis of the survey findings (exclusive to Horizon 2); and
- Positive and negative implications for each horizon through the integration of qualitative and quantitative data.
4. Discussion
4.1. Short Term: Make It Clearer
4.2. Medium Term: Make It Simpler
4.3. Long Term: Make It Smarter
4.4. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Demographic Attribute | Category | Total (n) | ercentage (%) |
---|---|---|---|
Gender | Female | 915 | 72.6 |
Male | 346 | 27.4 | |
Age | 18–24 years old | 149 | 11.8 |
25–34 years old | 493 | 39.1 | |
35–49 years old | 441 | 35.0 | |
50+ years old | 178 | 14.1 | |
Race | Black | 730 | 57.9 |
Colored | 156 | 12.4 | |
White | 274 | 21.7 | |
Indian/Asian | 93 | 7.4 | |
Prefer not to answer | 6 | 0.5 | |
Other | 2 | 0.2 | |
Household Income (monthly) | Less than ZAR 5000 | 365 | 28.9 |
ZAR 5000–ZAR 9999 | 239 | 19.0 | |
ZAR 10,000–ZAR 19,999 | 232 | 18.4 | |
ZAR 20,000–ZAR 29,999 | 155 | 12.3 | |
ZAR 30,000–ZAR 69,999 | 203 | 16.1 | |
ZAR 70,000+ | 67 | 5.3 | |
Education | Less than Grade 12 | 94 | 7.5 |
Grade 12 | 394 | 31.2 | |
Trade or vocational training | 247 | 19.6 | |
Diploma | 253 | 20.1 | |
Degree or Postgraduate Degree | 273 | 21.6 | |
Children (<18 years) in Household | 0 | 356 | 28.2 |
1 | 340 | 27.0 | |
2 | 359 | 28.5 | |
3 | 147 | 11.7 | |
4+ | 59 | 4.7 | |
Household size (Total) | 1 | 74 | 5.9 |
2 | 206 | 16.3 | |
3 | 248 | 19.7 | |
4 | 286 | 22.7 | |
5 | 213 | 16.9 | |
6 | 116 | 9.2 | |
7+ | 118 | 9.4 | |
Province of residence | Gauteng | 615 | 48.8 |
Western Cape | 225 | 17.8 | |
KwaZulu-Natal | 188 | 14.9 | |
Rest of South Africa | 233 | 18.5 | |
Industry of employment | Arts, Entertainment, Recreation | 44 | 3.5 |
Unemployed | 263 | 20.9 | |
Education | 102 | 8.1 | |
Food | 58 | 4.6 | |
Financial Services | 73 | 5.8 | |
Government, Public Administration | 92 | 7.3 | |
Healthcare | 65 | 5.2 | |
Media, Advertising, Public Relations | 68 | 5.4 | |
Mining, Construction | 60 | 4.8 | |
Scientific or Technical Services | 22 | 1.7 | |
Student | 94 | 7.5 | |
Telecommunications | 42 | 3.3 | |
Other | 278 | 22.0 | |
Relationship status | Single | 440 | 34.9 |
In a relationship | 359 | 28.5 | |
Married | 387 | 30.7 | |
Divorced | 56 | 4.4 | |
Other | 19 | 1.5 | |
Smoking status | Non-smoker | 800 | 63.4 |
Smoker | 229 | 18.2 | |
Occasional smoker | 122 | 9.7 | |
Ex-smoker | 110 | 8.7 | |
Physical activity level | Inactive | 297 | 23.6 |
Less than 150–300 min moderate-intensity exercise OR 75–150 min high-intensity exercise in a week | 511 | 40.5 | |
About 150–300 min moderate-intensity exercise OR 75–150 min high-intensity exercise in a week | 327 | 25.9 | |
More than 150–300 min moderate-intensity exercise OR 75–150 min high-intensity exercise in a week | 126 | 10.0 | |
Shopping responsibility | Shared responsibility | 430 | 34.1 |
Sole responsibility | 831 | 65.9 | |
Cereal purchased | Occasional/Sometimes | 171 | 13.6 |
Yes | 1090 | 86.4 | |
How well do you understand food labels? | Not at all | 45 | 3.6 |
A little | 110 | 8.7 | |
Fifty-fifty | 268 | 21.3 | |
Fairly well | 391 | 31.0 | |
Very well | 447 | 35.4 | |
Do food labels inform your food choices? | Not at all | 91 | 7.2 |
A little | 126 | 10.0 | |
Fifty-fifty | 297 | 23.6 | |
Fairly well | 362 | 28.7 | |
Very well | 385 | 30.5 | |
Most searched nutrients on food labels (all that apply) | Sugar | 897 | 71.1 |
Energy | 849 | 67.3 | |
Fat | 787 | 62.4 | |
Carbohydrates | 752 | 59.6 | |
Protein | 734 | 58.2 | |
Sodium | 510 | 40.4 | |
Do not use label at all | 113 | 9.0 | |
Main factor influencing food choices | Health | 521 | 41.3 |
Price | 367 | 29.1 | |
Taste | 218 | 17.3 | |
Brand | 126 | 10.0 | |
Appearance | 23 | 1.8 | |
Other | 6 | 0.5 | |
Main source of health information | Food labels | 389 | 30.8 |
Doctor or dietician | 263 | 20.9 | |
Social Media | 214 | 17.0 | |
Books and Magazines | 165 | 13.1 | |
Friends and Family | 129 | 10.2 | |
Television or radio | 57 | 4.5 | |
Other | 44 | 3.5 |
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Todd, M.; Guetterman, T.; Volschenk, J.; Kidd, M.; Joubert, E. Healthy or Not Healthy? A Mixed-Methods Approach to Evaluate Front-of-Pack Nutrition Labels as a Tool to Guide Consumers. Nutrients 2022, 14, 2801. https://doi.org/10.3390/nu14142801
Todd M, Guetterman T, Volschenk J, Kidd M, Joubert E. Healthy or Not Healthy? A Mixed-Methods Approach to Evaluate Front-of-Pack Nutrition Labels as a Tool to Guide Consumers. Nutrients. 2022; 14(14):2801. https://doi.org/10.3390/nu14142801
Chicago/Turabian StyleTodd, Melvi, Timothy Guetterman, Jako Volschenk, Martin Kidd, and Elizabeth Joubert. 2022. "Healthy or Not Healthy? A Mixed-Methods Approach to Evaluate Front-of-Pack Nutrition Labels as a Tool to Guide Consumers" Nutrients 14, no. 14: 2801. https://doi.org/10.3390/nu14142801