Chinese consumers' psychology and behavior of the foods with nutrition claims based on AISAS model.

Objective: We analyzed the impact of nutrition claims on Chinese consumer psychology and behavior process based on the theoretical framework of AISAS (Attention-Interest-Search-Action-Share) model. Design: To adopt questionnaires to collect gender, age, income and other basic information of adult residents and a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree) to collect data on residents' attention to nutrition claims, interest in nutrition claims, search on nutrition claim information, purchasing behavior on food with nutrition claims, sharing information on food with nutrition claims. Then to study the relationship between the basic situation of residents and their attention, interest, search, food purchase behavior and sharing of nutrition claims by using exploratory factor analysis, reliability and validity test, structural equation modeling estimation and hypothesis testing. Participants: Chinese adults. Setting: Multi-stage stratified random sampling method was used to collect the valid online questionnaire of 630 Chinese adults from Central, North, East, South, Northwest, Southwest, and Northeast China. Results: Younger adults and those with higher household incomes exhibited heightened attention to nutrition claims. Furthermore, consumers' attention to nutrition claims could be transformed into food information sharing through interest, information search, and food purchase. Consumers' interest in food with nutrition claims could be transformed directly into food purchase. Consumers' search for related information could be directly transformed into food information sharing. Conclusion: Chinese consumers' age and household income could be included in the AISAS model for the foods with nutrition claims, and the consumers' action and share could transform from their interest and search.

Assessing transnational spillover effects of Mexico's front-of-package nutritional labeling system among Mexican Americans in the US.

OBJECTIVE: In 2020, Mexico implemented innovative front-of-package nutrition warning labels (FoPWLs) for packaged foods to increase the salience and understanding of nutrition information. This study evaluated Mexican Americans' self-reported exposure to Mexican FoPWLs and self-reported effects of FoPWLs on purchasing behavior. METHODS: The 2021 International Food Policy Study surveyed online panels of adult Mexican Americans in the US (n = 3361) to self-report on buying food at Mexican-oriented stores, noticing Mexican FoPWLs, and being influenced by FoPWLs to purchase less of eight different unhealthy foods (each assessed separately). After recoding the frequency of buying foods in Mexican stores and noticing FoPWLs (i.e., "often" or "very often" vs. less often), logistic models regressed these outcomes on sociodemographics, adjusting for post-stratification weights. RESULTS: Most participants (88.0%) purchased foods in Mexican stores. Of these, 64.1% reported noticing FoPWLs, among whom many reported that FoPWLs influenced them to buy fewer unhealthy foods (range = 32% [snacks like chips] - 44% [colas]). Participants were more likely to buy foods in Mexican stores and notice FoPWLs if they were younger, had ≥two children at home vs no children (AOR = 1.40, 95%CI = 1.15-1.71; AOR = 1.37, 95%CI = 1.03-1.80, respectively), and more frequently used Spanish (AOR = 1.91, 95%CI = 1.77-2.07; AOR = 1.87, 95%CI = 1.69-2.07). Also, high vs. low education (AOR = 1.51, 95%CI = 1.17-1.94) and higher income adequacy (AOR = 1.37, 95%CI = 1.25-1.51) were positively associated with noticing FoPWLs. Being female and more frequent Spanish use were consistently associated with reporting purchase of fewer unhealthy foods because of FoPWLs. CONCLUSIONS: Many Mexican Americans report both exposure to Mexican FOPWLs and reducing purchases of unhealthy foods because of them.

Chinese Adults' Willingness to Pay for Mandatory Nutrients Reporting on Nutrition Facts Table.

The Chinese food industry has opposed the mandatory inclusion of increased nutrients in the Nutrition Facts Table (NFT), thus impeding its improvement. This poses a challenge to the endeavors aiming to assist consumers in cultivating healthy dietary habits that incorporate reduced saturated fatty acids and added sugars while ensuring the adequate intake of essential micronutrients. This study conducted a choice experiment to investigate Chinese consumers' preference for updated labeling schemes among 630 adults that were randomly selected from Central, North, East, South, Northwest, Southwest, and Northeast China. It revealed that respondents were willing to pay the highest premium for the most mandatory nutrients (22.575% of the food price per unit). Respondents preferred the NFT with the most mandatory nutrients if they met the following population characteristics: female; non-overweight or obese; without a college degree; possessed an annual household disposable income between 50,000 and 99,999 CNY; from North China; lived in rural areas and often cooked for family; cared about food nutrition. Two combinations of NFT information received the highest preference: (1) the NFT detailing the most mandatory nutrients and their content values and nutrient reference values (NRV%); (2) the NFT containing the most nutrients and the nutrients in 100 g/mL or a serving. The first and second combinations attracted a premium of 14.884% and 31.833% of the food price per unit, respectively.

Parent Experiences With Warning Labels After Policy Implementation in Uruguay.

OBJECTIVE: To explore the perception and experiences of parents of children and adolescents during the first year of the mandatory implementation of nutritional warning labels in Uruguay. DESIGN: Qualitative research based on semistructured interviews. SETTING: Montevideo, Uruguay. PARTICIPANTS: Twenty-eight parents of children and adolescents. PHENOMENON OF INTEREST: Perception of and experiences with warning labels, a front-of-pack nutrition labeling scheme that has become increasingly popular in Latin America. ANALYSIS: Content analysis of the transcripts based on a deductive-inductive approach. RESULTS: Interview transcripts evidenced high awareness, acceptance, and understanding of warning labels among parents of children and adolescents. Most participants reported considering warnings for decision making and changing their purchase decisions because of their implementation, particularly when choosing foods for their children. They reported their children were aware of and understood warnings but did not tend to take them into account when choosing foods. CONCLUSIONS AND IMPLICATIONS: Results from the present work contribute to the growing body of literature showing the effectiveness of warning labels. Lack of interest or perceived benefits and structural barriers emerged as key motives for not using the warnings when making purchasing decisions, suggesting the need to develop additional strategies to increase policy effectiveness.

The Role of Front-of-Package Nutrition Labels with and without Explanatory Videos on Parent and Child Food Choices.

The aim of this research was to determine whether parent/child pairs choosing products from a grocery aisle labeled with front-of-package (FOP) nutrition labels would make more healthful choices than pairs who viewed the same items without labels, and to determine the added value of viewing an explanatory video before choosing. In this experiment, 175 parent/child pairs chose USD 20 worth of packaged foods and beverages from a grocery aisle in a research laboratory and were randomly assigned to see products that either did or did not have 0-4-star FOP labels, with more stars indicating more healthful products. Among those participants with access to FOP labels, half were randomly assigned to view a 30 s video explaining the FOP labels before selecting foods. Participants who saw the explanatory video before selecting among products with FOP labels chose foods with significantly more stars than participants who saw the FOP-labeled products without the video; however, there was no significant difference in mean stars on selected products between the group that saw the videos and the control group that saw neither the video nor FOP labels. We conclude that explaining new FOP labels to consumers may be necessary for the labels to prompt more healthful choices.

Uptake of Front-of-Package Nutrition Labeling Scheme after 5 Years of Adoption in Thailand: An Analysis of New Launched Pre-Packaged Food and Beverages Products.

In 2016, Thailand introduced voluntary front-of-pack nutrition labeling, the 'Thailand Healthier Choice' logo (THCL), in order to help consumers make informed, healthier food choices in each food category. This study aimed to assess the uptake of the THCL scheme in Thailand after five years of implementation by analyzing a newly launched product database. Data on the nutritional composition and labeling were obtained from the Mintel Global New Products Database between 2017 and 2021. The product's healthfulness was determined using the Health Star Rating (HSR) algorithm. The numbers and proportions of total, eligible, and labeled products bearing the THCL logo were analyzed and classified by food category, by HSR value, and by manufacturer. After 5 years of implementation, THCL uptake as a proportion of total products and eligible products continues to increase by 3.0% and 10.2% per annum, respectively. The logo has correspondingly appeared on 10.7% and 39.5% of total and eligible products. As a voluntary implementation, 76.1% of products displaying the THCL logo belonged to the 'non-core' group, i.e., non-alcoholic beverages and instant foods. This food category (HSR < 3.0) was more likely to register to bear THCL rather than those 'core' food scoring an HSR ≥ 3.5, which might reflect economic considerations and benefits. The present analysis also found that only 10% of manufacturers in Thailand launched 'healthier' products that display the THCL logo with varied product numbers. To summarize, the initial five-year implementation of the THCL program shows promise, but its adoption remains limited and inconsistent, thereby restricting its influence on public health. Our discoveries highlight the limitations of commercial goodwill in applying THCL voluntarily in Thailand and offer potential suggestions to enhance its adoption in the coming years.

Comparative Assessment of the Nutritional Profile of Meat Products and Their Plant-Based Analogues.

Vegetarian and vegan diets are increasingly being adopted in Spain, a trend mainly driven by ethical concerns for animal welfare and the environment. This has resulted in a growing market for plant-based substitutes of meat products. However, available data on the nutritional value of such meat analogues in Mediterranean countries are still limited. In this study, the labelling information of four categories of plant-based meat analogues (n = 100) and the corresponding conventional meat products (n = 48) available on the Spanish market was surveyed and compared. The nutrient content of plant-based meat analogues varied significantly, due to the wide range of ingredients used in their formulation. Some of these products were found to have a low protein content, which in others was enhanced by the addition of cereals and legumes. Compared to the meat products, the plant-based analogues contained lower levels of total fat as well as saturated fat, which ranged from 30% of total fat in burgers to less than 15% in meatballs, sausages, and nuggets; in contrast, they contained higher amounts of fiber and complex carbohydrates. Overall, the meat analogues cannot be considered as nutritionally equivalent substitutes to conventional meat products due to a high variability of protein content and other nutrients.

Awareness, use and understanding of nutrition labels among children and youth from six countries: findings from the 2019 - 2020 International Food Policy Study.

BACKGROUND: Nutrition facts tables (NFTs) on pre-packaged foods are widely used but poorly understood by consumers. Several countries have implemented front-of-package labels (FOPLs) that provide simpler, easier to use nutrition information. In October 2020, Mexico revised its FOPL regulations to replace industry-based Guideline Daily Amount (GDA) FOPLs with 'Warning' FOPLs, which display stop signs on foods high in nutrients of concern, such as sugar and sodium. This study examined self-reported awareness, use, and understanding of NFTs and FOPLs among young people in six countries with different FOPLs, with an additional focus on changes before and after implementation of Mexico's FOPL warning policy. METHODS: A 'natural experiment' was conducted using 'pre-post' national surveys in Mexico and five separate comparison countries: countries with no FOPL policy (Canada and the US), countries with voluntary FOPL policies (Traffic Lights in the UK and Health Star Ratings in Australia), and one country (Chile) with mandatory FOPL 'warnings' (like Mexico). Population-based surveys were conducted with 10 to 17-year-olds in 2019 (n = 10,823) and in 2020 (n = 11,713). Logistic regressions examined within- and between-countries changes in self-reported awareness, use, and understanding of NFTs and FOPLs. RESULTS: Across countries, half to three quarters of respondents reported seeing NFTs 'often' or 'all the time', approximately one quarter reported using NFTs when deciding what to eat or buy, and one third reported NFTs were 'easy to understand', with few changes between 2019 and 2020. In 2020, awareness, use and self-reported understanding of the Warning FOPLs in Mexico were higher than for NFTs in all countries, and compared with GDA FOPLs in Mexico (p < .001). Mandated Warning FOPLs in Mexico and Chile had substantially higher levels of awareness, use, and understanding than the voluntary Traffic Lights in the UK and Health Star Ratings in Australia (p < .001 for all). CONCLUSIONS: Mandated easy-to-understand FOPLs are associated with substantially greater levels of self-reported awareness, use and understanding at the population-level compared to NFT and GDA-based labeling systems.

Status of nutrition labeling knowledge, attitude, and practice (KAP) of residents in the community and structural equation modeling analysis.

Objective: Unhealthy foods were a major contributor to the occurrence of chronic non-communicable diseases. The promotion of nutrition labeling in the community can effectively help residents to choose healthy foods, which plays an important role in the prevention of chronic diseases. However, the public awareness of this measure is not clear. Our study used a structural equation model based on the KAP theory to analyze the interaction mechanisms among knowledge, attitude, and practice and aimed to evaluate the relationships among nutrition knowledge, attitude, and practice of residents, which can provide the basis of policy formulation for nutrition education and behavior intervention. Methods: We carried out a cross-sectional study from May 2022 to July 2022 in the "Community Health Service Center", and each "Community Service Station" in Yinchuan use a self-designed questionnaire and convenience sampling to evaluate resident nutrition labeling KAP status. This study adopted the structural equation modeling approach to analyze a survey of Chinese individuals through the cognitive processing model, interrelated nutrition knowledge, nutrition label knowledge, attitude, and practice. Results: According to the principle of sample size estimation, a total of 636 individuals were investigated, with the ratio of male to female being 1:1.2. The average score of community residents' nutrition knowledge was 7.48 ± 3.24, and the passing rate was 19.4%. Most residents had a positive attitude toward nutrition labeling, but the awareness rate was only 32.7% and the utilization rate was 38.5%. Univariate analysis showed that women had higher knowledge scores than men (p < 0.05), and young people had higher scores than older adults (p < 0.05), and the difference was significant. Based on the KAP structural equation model (SEM), residents' nutrition knowledge will directly affect their attitude toward nutrition labeling. Attitude played a greater role as an indirect effect between knowledge and behavior, while trust limits residents' practice of nutrition labeling and then affects their practice. It could be explained that nutrition knowledge was the prerequisite for label reading behavior, and attitude was the intermediary effect. Conclusion: The nutrition knowledge and nutrition labeling knowledge of respondents hardly directly support the practice of nutrition labeling, but it can influence the use behavior by forming a positive attitude. The KAP model is suitable for explaining residents' use of nutrition labeling in the region. Future research should focus on better understanding the motivations of residents to use nutrition labeling and the opportunity to use nutrition labeling in real-life shopping settings.

Qualitative analysis of front-of package labeling policy interactions between stakeholders and Health Canada.

Background: Front-of-package labelling regulations proposed by Health Canada in their Healthy Eating Strategy (2016) were finally passed in 2022, but remain unimplemented. This study analyzed interactions that occurred between stakeholders and government related to this policy proposal to identify key themes and policy implications. Methods: A qualitative framework analysis was conducted on publicly available documents for stakeholder correspondences related to front-of-package that occurred between 2016 and 2019 in Health Canada's Meetings and Correspondence on Healthy Eating database. Five sequential steps were applied: familiarization, identifying a thematic framework, indexing, charting, and mapping and interpretation. A complex systems (i.e., a dynamic system with multiple interconnecting components) lens was incorporated in the final step to deepen the analysis. Results: Hundred and seventy-three documents were included, the majority from industry stakeholders (n = 108, 62.4%). Three overarching themes were identified: industry trying to control the agenda and resist regulation; questioning the evidence supporting the policy and its impact on the agri-food industry; and dismissing the need and effectiveness of the policy. Incorporating a complex system lens found industry and non-industry stakeholders held markedly different perspectives on how cohesive the system defined by the front-of-package labelling policy was, and the policy impact on its stability. Economic and opportunity costs were the main trade-offs, and symbol misinterpretation considered an unintended consequence by industry. Finally, some stakeholders argued for wider policy scope incorporating more products, while others requested a narrower approach through exemptions. Conclusion: Interactions with industry stakeholders on health food policy proposals require careful consideration, given it may suit their interests to generate delays and policy discordance. Explicitly setting out the principles of engagement and actively encouraging non-industry stakeholder representation provides a more balanced approach to policy consultation and development.

Association of Social Networking Sites Use with Actual and Ideal Body Shapes, and Eating Behaviors in Healthy Young Japanese Women.

Recent reports have associated the use of social networking sites (SNS) with the drive for thinness in young women; however, its influence on their actual body shape and eating behaviors (EB) remains unclear. We aimed to examine the effect of SNS use on body mass index (BMI), body image (BI), and EB in young women. Participants included 196 healthy women (20-29 years) who answered questions about their SNS use, height, weight, BI and EB via a web-based survey. First, the correlation between time spent on SNS and each variable was determined. Participants were then divided into quartiles according to the duration of daily SNS use as long (≥3 h, n = 52) and short (<1 h, n = 54), and the data were then compared between the groups. Correlation analysis showed that the longer the duration of daily SNS use, the significantly lower the BMI, the use of nutrition labels, and the frequency of consumption of milk and dairy products. The long group had significantly lower BMI and ideal BI than the short group. The results suggest that spending more time on SNS in young women may be associated with thinner actual and ideal body shapes and poorer access to health information and healthy foods.

A policy study on front-of-pack nutrition labeling in the Americas: emerging developments and outcomes.

Poor nutrition is one of the leading causes of non-communicable diseases (NCDs), especially in the WHO Region of the Americas (AMRO). In response, international organisations recommend front-of-pack nutrition labelling (FOPNL) systems that present nutrition information clearly to help consumers make healthier choices. In AMRO, all 35 countries have discussed FOPNL, 30 countries have formally introduced FOPNL, eleven have adopted FOPNL, and seven countries (Argentina, Chile, Ecuador, Mexico, Peru, Uruguay and Venezuela) have implemented FOPNL. FOPNL has gradually spread and evolved to better protect health by increasingly adopting larger warning labels, contrasting background devices for better salience, using "excess" instead of "high in" to improve efficacy, and adopting the Pan American Health Organization's (PAHO) Nutrient Profile Model to better define nutrient thresholds. Early evidence illustrates successful compliance, decreased purchases and product reformulation. Governments still discussing and waiting to implement FOPNL should follow these best practices to help reduce poor nutrition related NCDs. Translated versions of this manuscript are available in Spanish and Portuguese in the supplementary material.

Awareness, use and understanding of nutrition labels among adults from five countries: Findings from the 2018-2020 International Food Policy Study.

Few studies have compared the effects of different front-of-package label (FOPL) systems in the 'real world'. This study assessed adults' awareness, use and understanding of nutrition facts labels (NFLs) and nationally implemented FOPLs such as Health Star Ratings (HSR), Traffic lights, and Guideline Daily Amounts (GDAs) in five countries, including before and after implementation of Mexico's warning FOPLs in 2020. Data were from the International Food Policy Study, an annual repeat cross-sectional study conducted in 2018-2020 among adults (N=64,032) in Australia, Canada, Mexico, the UK and the US. Self-reported awareness, use, and understanding of NFLs (in all five countries) and FOPLs (in Australia, Mexico, and UK) were assessed over time, between countries, and between NFLs and FOPLs. Most respondents in all countries reported seeing their country's NFLs (awareness) 'often' or 'all the time' across all three years, with one third to half of respondents using NFLs 'often' or 'all the time' (Australia: 43-45%; Canada: 47-50%; Mexico: 36-39%; UK: 32-34%; US: 47-49%), and approximately one half to two thirds finding NFLs 'easy' or 'very easy to understand' (56-57%; 67-69%; 51-54%; 48-51%; 70-71%). In 2020, awareness, use and self-reported understanding of the Warning FOPLs in Mexico were highest among all countries with a FOPL (p<0.001), whereas awareness and use were lowest for Australia's HSR (p<0.001). In countries with FOPLs, self-reported understanding was higher for FOPLs than NFLs, except for the GDA FOPL in Mexico. Only modest changes were observed over time. Warning FOPLs were associated with greater levels of self-reported awareness, use and understanding among adults compared to NFLs and GDA-based FOPLs. FOPLs implemented on a voluntary basis, such as Australia's HSR, may be less likely to be seen and used.

Front-of-package nutrition labeling as a driver for healthier food choices: Lessons learned and future perspectives.

This work aims to provide a comprehensive overview of the use of front-of-package nutritional labeling (FOPL), identify and characterize the major existing FOPL systems, examine the impact of FOPL systems on consumer behavior, and discuss future perspectives. The searched databases were PubMed, Scopus, and Web of Science, and papers in English, Portuguese, Spanish, and French were considered. The integrative review method was used, comprising 68 papers. The FOPL system from more than 47 countries from North America, South America, Africa, Europe, Australia, and Asia was included in this study. The two main ways to characterize FOPL are the level of interpretation and the type of information provided. Interpretive schemes (such as warning labels, multiple traffic lights, and Nutri-Score) appear to lead to better consumer understanding and support healthier food purchases. However, due to the differences among the results and the specificity of the contexts in which they are used, it is impossible to define one FOPL interpretation scheme superior to the others. Some potential factors that influence the effectiveness of FOPL on consumer attitudes have been identified, such as food taste, as a major intrinsic factor. Extrinsic factors, such as price, food category, cultural diversity, politics, and economics, were also relevant. The lack of availability of similar alternatives, lack of understanding of the importance of FOPL, and lower levels of income and education were also some cognitive and social aspects impairing FOPL effectiveness. Prospects for the United States, Europe, Brazil, Colombia, and Argentina were discussed.

Nutritional Assessment of Ready-to-Eat Salads in German Supermarkets: Comparison of the nutriRECIPE-Index and the Nutri-Score.

Globally, an unbalanced diet causes more deaths than any other factor. Due to a lack of knowledge, it is difficult for consumers to select healthy foods at the point of sale. Although different front-of-pack labeling schemes exist, their informative value is limited due to small sets of considered parameters and lacking information on ingredient composition. We developed and evalauated a manufacture-independent approach to quantify ingredient composition of 294 ready-to eat salads (distinguished into 73 subgroups) as test set. Nutritional quality was assessed by the nutriRECIPE-Index and compared to the Nutri-Score. The nutriRECIPE-Index comprises the calculation of energy-adjusted nutrient density of 16 desirable and three undesirable nutrients, which are weighted according to their degree of supply in the population. We show that the nutriRECIPE-Index has stronger discriminatory power compared to the Nutri-Score and discriminates as well or even better in 63 out of the 73 subgroups. This was evident in groups where seemingly similar products were compared, e.g., potato salads (Nutri-Score: C only, nutriRECIPE-Index: B, C and D). Moreover, the nutriRECIPE-Index is adjustable to any target population's specific needs and supply situation, such as seniors, and children. Hence, a more sophisticated distinction between single food products is possible using the nutriRECIPE-Index.

Conocimientos de la población adulta sobre etiquetado nutricional de alimentos

Los consumidores a menudo informan dificultades para interpretar la información cuantitativa contenida en las etiquetas nutricionales de los alimentos. El objetivo fue estudiar los principales conocimientos sobre etiquetado de alimentos que la población adulta del Paraguay tiene incorporado en el periodo de agosto de 2021. Este es un estudio descriptivo observacional de corte trasversal en el cual se evaluaron a adultos de ambos sexos de 18 a 60 años consumidores de alimentos con etiquetado nutricional. Se recabarón datos sociodemográficos y de conocimientos sobre etiquetado nutricional de alimentos a través de una encuesta tipo on-line con la herramienta de Google forms. El 73% fueron del sexo femenino, la edad promedio fue de 36,9 años, 57,1% residía en Gran Asunción, 49,1% tenía nivel educativo universitario y 37,5%eran profesionales de la salud. Los aspectos generales sobre etiquetado nutricional revelaron que 88,3% sabía su concepto, 55,3% refirió que lo lee casi siempre, 84% sabía que es obligatorio y 44% se fijaba más en las calorías. Al evaluar los conocimientos generales, 91% sabía la diferencia entre caducidad y consumo preferente, 71,4% conocía el concepto de cantidades orientativas, 62,5% supo cuáles son las grasas menos saludables, y 71,4% respondió correctamente el concepto de alimento light. Los encuestados tuvieron un conocimiento general adecuado sobre etiquetado nutricional, no obstante, hubo un porcentaje considerable de individuos que no supieron los conceptos básicos, por lo que se debe realizar intervenciones de educación nutricional enfocadas al consumidor.

Consumers often report difficulties in interpreting the quantitative information contained in the nutritional labels of foods. The objective was to study the main knowledge about food labeling that the adult population of Paraguay has incorporated in the period of August 2021. This is a cross-sectional descriptive observational study in which male and female adults between 18 and 60 years old consumers of foods with nutrition labelling were evaluated. Sociodemographic data and knowledge about nutritional labeling of food was collected through an online survey with the Google forms tool. Seventy three percent was female, the average age was 36.9 years, 57.1% lived in Greater Asunción, 49.1% had a university education level, and 37.5% were health professionals. The general aspects about nutritional labeling revealed that 88.3% knew the concept, 55.3% said that they read it almost always, 84% knew that it was mandatory and 44% paid more attention to calories. When evaluating general knowledge, 91% knew the difference between expiration and preferential consumption, 71.4% knew the concept of indicative quantities, 62.5% knew which are the less healthy fats, and 71.4% correctly answered the concept of light food. The survey respondents had an adequate general knowledge about nutrition labeling, however, there was a considerable percentage of individuals who did not know the basic concepts, for which consumer-focused nutrition education interventions should be carried out.

Corrigendum: Comparison of two front-of-pack nutrition labels for Brazilian consumers using a smartphone app in a real-world grocery store: A pilot randomized controlled study.

[This corrects the article DOI: 10.3389/fnut.2022.898021.].

Comparison of two front-of-pack nutrition labels for Brazilian consumers using a smartphone app in a real-world grocery store: A pilot randomized controlled study.

One of the suggestions for improving the understanding of food labels is implementing front-of-pack nutrition labeling (FoPNL), where nutritional information is objectively made available to consumers. Scientific data on the best FoPNL model to be adopted for the Brazilian population is still emerging, especially in real-world purchase situations. This study aims to evaluate/compare the proposed Brazilian and Mexican FoPNL systems, on different outcome measures, using an application, in dairy foods available in a supermarket aisle. This pilot randomized controlled trial in a real-world purchase situation was conducted in June/July 2021. A total of 230 participants were randomly allocated to one of the three study arms (Mexican and Brazilian FoPNL systems or control-nutritional information table and ingredients list). Using a smartphone, the participants scanned a product barcode and received the allocated FoPNL (with information about excessive added sugars, sodium, and/or saturated fat content) or the control. After, they answered questions related to our primary outcome (decision to buy or not to buy a product) and secondary outcomes (perceived healthiness, facilitation of a quick purchase decision, and identification of excess nutrients). The Mexican FoPNL system performed better in the primary outcome (3.74 ± 1.34) and "facilitation of a quick purchase decision" (3.59 ± 1.31), compared to the control (3.28 ± 1.45;p = 0.043 and 3.11 ± 1.42; p = 0.029). The Mexican FoPNL system performed better in supporting consumers to identify dairy foods, among the selected sample in this study, high in added sugars than the control (82.2% and 63.5% of correct answers, respectively; p = 0.009). For saturated fats, the Brazilian FoPNL resulted in 93.1% of correct answers against 48.2% for the control and 58.9% for the Mexican system (p ≤ 0.001). The Mexican FoPNL system facilitated consumer decision-making on when to buy or not to buy a selected dairy product and in helping to quickly decide which dairy products to buy, among the selected sample in this study, compared to the control. Considering the right answers of critical nutrients in excess or not, both models of FoPNL, delivered by a smartphone app, performed well.