Simplifying mental math: Changing how added sugars are displayed on the nutrition facts label can improve consumer understanding.

BACKGROUND: Proposed variations to Nutrition Facts Labels (NFL) have included the display of added sugars (AS) content, but its impact on consumer understanding is poorly understood. OBJECTIVE: To examine the degree to which different formats for displaying AS influence consumer understanding, perceptions, and purchase intentions. DESIGN: Randomized-controlled online experiment. PARTICIPANTS: A sample of 2509 U.S adults. INTERVENTION: Participants were randomized to 1 of 8 conditions and viewed 10 food or beverage images with either: (1) no label (control); (2) the current NFL (without AS); (3) the proposed NFL without AS; or the proposed NFL with AS in (4) grams, (5) grams and teaspoons, (6) grams and percent Daily Value (%DV), (7) grams with high/medium/low text, or (8) grams with high/medium/low text and %DV. MAIN OUTCOME MEASURES & STATISTICAL ANALYSIS: ANCOVAs compared scores on quizzes that assessed the accuracy of judgments about AS, overall nutrition understanding and purchase intentions. RESULTS: Presenting AS in grams plus high/medium/low text with and without %DV led to the highest AS understanding scores (85% and 83% correct, respectively) compared to 70% correct when AS was not on the label or was displayed in grams only (74% correct). Displaying AS in teaspoons did not significantly improve understanding beyond grams alone. Consumers were best able to determine which of two products was healthier when AS was presented as %DV (68% correct) versus displayed in grams alone (60% correct), but %DV did not differ from high/medium/low text or teaspoons. None of the labels influenced purchase intentions relative to no label. CONCLUSION: Displaying AS on the NFL in grams with high/medium/low text, %DV, or the combination of the two, improved consumer understanding more than presenting it in grams or teaspoons.