Effects of front-of-package nutrition labelling systems on objective understanding and purchase intention in Panama: results from a multi-arm parallel-group randomised controlled trial.

OBJECTIVE: To assess the effect of different front-of-package (FOPL) schemes on the objective understanding of the nutritional content and intention to purchase products, in Panama. DESIGN: Single-blinded multi-arm parallel-group randomised controlled trial. SETTING: Supermarkets across Panama. Participants were exposed to two-dimensional images of 15 mock-up products presented at random and balanced orders. Participants assigned to the intervention groups were exposed to mock-ups featuring one FOPL scheme: black octagonal warning labels (OWL), traffic-light labelling (TFL), or guideline daily amounts (GDA). Control group was not exposed to any FOPL scheme. PARTICIPANTS: Adult supermarket shoppers (n=1200). Participants were blinded to group assignment. RESULTS: Similar number of participants were randomised to and analysed in each group: OWL (n=300), TFL (n=300), GDA (n=300), and control (n=300). The odds for choosing to purchase the least harmful or none of the options more often was the highest in the OWL group. Compared to the control group, two times higher in the OWL group (OR 2·13, 95% confidence interval 1·60-2·84), and 57% higher in the TFL (1·57, 1·40-2·56), with no changes in the GDA (0·97, 0·73-1·29). OWL also resulted in the highest odds for correctly identifying the least harmful option, and for correctly identifying a product with excessive amounts of sugars, sodium and/or saturated fats. CONCLUSIONS: OWL performed best in helping shoppers to correctly identify when a product contained excessive amounts of nutrients of concern, to correctly identify the least harmful option, and to decide to purchase the least harmful or none of the options, more often.

Influence of nutrition claims on different models of front-of-package nutritional labeling in supposedly healthy foods: Impact on the understanding of nutritional information, healthfulness perception, and purchase intention of Brazilian consumers.

Nutrition claims are positive information about foods, which are widely used as a marketing strategy on labels. On the contrary, front-of-package nutritional labeling (FoPNL) aims to make it easier for consumers to understand the nutritional composition of foods and favor healthy food choices. However, the concomitant presence of nutrition claims and FoPNL may hinder the understanding, judgment, and choices of consumers at the moment of purchase. Therefore, the objective of this study was to evaluate the influence of nutrition claims on the efficacy of FoPNL models in the understanding of nutritional information, healthfulness perception, and purchase intention of Brazilian consumers. It was an experimental cross-sectional study carried out using an online questionnaire, with a total of 720 participants randomly divided into four FoPNL conditions: control, octagon, triangle, and magnifying glass. Each participant looked at 12 food packages, which were produced following the factorial design: (i) food category (cereal bar, whole grain cookies, and snacks); (ii) product type (containing one critical nutrient × containing two critical nutrients); and (iii) nutrition claims (present × absent). The comprehension of nutritional information was evaluated through the identification of excessive nutrients, and the healthfulness perception and purchase intention were evaluated using a seven-point scale. The results indicated that the presence of FoPNL increased the understanding of the information and reduced healthfulness perception and purchase intention. The presence of nutrition claims influenced the three outcomes, decreasing the probability of understanding information about food composition by 32% (OR 0.68, 95% confidence interval 0.58-0.78, p < 0.01) and significantly increasing (p < 0.05) average health scores (1.95-2.02) and purchase intention (2.00-2.05). Nonetheless, the interaction "FoPNL × claims" was not significant, which indicated that claims act independently. All FoPNL models were more effective than the control. For the least healthful type of product (two nutrients in excess), the octagon and triangle models were superior to the magnifying glass, regarding the outcome of healthfulness perception. The results prove the efficacy of FoPNL in consumer understanding and judgment. Despite the positive effects of FoPNL, it did not cancel the positivity bias generated by the claims.

Choosing a front-of-package warning label for Brazil: A randomized, controlled comparison of three different label designs.

INTRODUCTION: Warning labels (WLs) are the newest paradigm of nutrient-based, front-of-package labels (FOP) that have been consistently shown to be more effective at informing consumer purchases than other FOP labels. Their effectiveness may be attributed to their design and the consistency in the information they communicate. The present study assessed designs effects of WLs in improving understanding and perceptions among 2419 Brazilian adults. METHODS: Participants were randomly assigned to one of four study arms in an online, randomized, controlled experiment: (1) the Triangular WL 'A lot of /Muito' (Muito); (2) Triangular WL 'High in/Alto em' (Alto); (3) the Chilean WL 'High in/Alto em' (Chile); and (4) a control condition (no WL). Participants responded to a series of questions, while viewing images of 9 products, that assessed their understanding of the nutrient content of the product, its healthfulness, and their intentions to purchase. All aggregate differences in responses between study arms were estimated using oneway-ANOVAs. RESULTS: WLs were superior to the list of ingredients and the nutrition facts panel in improving participant understanding and perceptions of the nutrient profile of products, particularly in helping identify nutrients in excess. Alto was significantly better than the control at identifying which of the two products contained an excess of nutrients and at improving consumer understanding of nutrient content across different indicators. Alto, followed by Muito, was also better at communicating that fewer WLs signified a healthier product. The Muito WL was significantly more visible to participants than the Chile WL. There were no differences between study arms in shifting consumer purchase intentions. CONCLUSIONS: In this study, WLs were an important addition to the current nutrition label. The triangular symbol, the white background and the signal word, 'High in/ Alto em' showed consistently better results than the signal word 'A lot of/ Muito' and the octagonal symbol. These design elements serve to make WLs more visible to consumers, capturing their attention and informing their food evaluations, and may have greater potential to influence appropriate for a Brazilian audience.

Informação nutricional em restaurantes: um estudo de compreensão de pictogramas / Nutritional information in restaurants: a study of pictogram comprehension

A informação nutricional em serviços de alimentação se mostra relevante para as escolhas alimentares, além de ser uma forma de respeitar o direito a escolha do consumidor. Contudo, é necessário que essa seja facilmente compreendida pelos comensais. Assim, o objetivo deste estudo é propor um modelo pictórico de informação nutricional, que alerte para presença de glúten, leite, ovo e carne em Restaurantes Universitários de uma instituição pública a partir da percepção dos consumidores e do conhecimento da nutrição e do design de informação. A pesquisa quali-quantitativa, com delineamento transversal e caráter exploratório, foi realizada em Curitiba, Paraná, com graduandos adultos de uma instituição pública. Por meio de um questionário autorrespondido, foram avaliadas a compreensão de pictogramas com e sem rótulo que representassem a presença de glúten, leite, carne e ovo, a relevância das informações apresentadas e a preferência do local da disponibilização da informação nutricional. Participaram 131 consumidores com idade média de 21,3 ± 2,6 anos, sendo 73,3% do sexo feminino. Observou-se boa percepção dos pictogramas propostos, sendo melhor compreendidos aqueles com rótulos, que representavam "contém ovo" e "contém carne". Em relação a presença de leite, o pictograma da garrafa foi o mais aceito. O local de preferência para a visualização da informação foi no buffet, havendo interesse, principalmente, no nome da preparação e na lista de ingredientes. Os modelos de pictogramas propostos se mostraram adequados conforme os consumidores, atingindo o objetivo do estudo, contribuindo para que as informações sejam facilmente compreendidas, e favorecendo o direito de escolha dos consumidores.

Nutritional information in food services is relevant to food choices, in addition to being a way of respecting the consumer's right to choose. However, it is necessary that this information to be easily understood by the diners. Thus, the aim of this study is to propose a pictorial model of nutritional information, which warns of the presence of gluten, milk, eggs, and meat in a public university restaurant based on the perception of consumers and the knowledge of nutrition and the information design. The quali-quantitative study, with a cross-sectional design and exploratory character, was carried out in Curitiba, Paraná, with adult students from a public institution. Through a self-answered questionnaire, the comprehension of pictograms with and without a label that represented the presence of gluten, milk, meat, and egg, the relevance of the information presented, and the preference of the place where the nutritional information was made available were evaluated. 131 consumers participated with an average age of 21.3 ± 2.6 years, 73.3% of whom were female. A good perception of the proposed pictograms was observed, and was better understood with labels, which represented "contains egg" and "contains meat". Regarding the presence of milk, the bottle pictogram was the most accepted. The preferred location for viewing the information was at the buffet, with interest mainly in the name of the meal and the list of ingredients. The proposed pictograms models were shown to be adequate according to consumers, reaching the objective of the study, making the information easily understood, and favoring the consumers' right to choose.