Next Article in Journal
Neonatal Nutrition Predicts Energy Balance in Young Adults Born Preterm at Very Low Birth Weight
Previous Article in Journal
The Effect of Red Palm Oil on Vitamin A Deficiency: A Meta-Analysis of Randomized Controlled Trials
Open AccessArticle

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

The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia
The Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
Royal Prince Alfred Hospital, University of New South Wales, Sydney, NSW 2050, Australia
Department of Epidemiology and Biostatistics, Imperial College London, London SW7 2AZ, UK
Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA
National Heart Foundation of Australia, Melbourne, VIC 3000, Australia
Bupa, Brisbane, QLD 4001, Australia
National Institute for Health Innovation, University of Auckland, Auckland 1010, New Zealand
School of Psychology and Speech Pathology, Curtin University, Bentley, WA 6102, Australia
School of Health and Social Development, Deakin University, Melbourne, VIC 3008, Australia
Author to whom correspondence should be addressed.
Nutrients 2017, 9(12), 1284;
Received: 11 October 2017 / Revised: 10 November 2017 / Accepted: 19 November 2017 / Published: 24 November 2017
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. View Full-Text
Keywords: food labelling; food industry; food purchases; policy; randomised trial food labelling; food industry; food purchases; policy; randomised trial
Show Figures

Figure 1

MDPI and ACS Style

Neal, B.; Crino, M.; Dunford, E.; Gao, A.; Greenland, R.; Li, N.; Ngai, J.; Ni Mhurchu, C.; Pettigrew, S.; Sacks, G.; Webster, J.; Wu, J.H.Y. Effects of Different Types of Front-of-Pack Labelling Information on the Healthiness of Food Purchases—A Randomised Controlled Trial. Nutrients 2017, 9, 1284.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

Back to TopTop