Ni Mhurchu Cliona, Volkova Ekaterina, Jiang Yannan, Eyles Helen, Michie Jo, Neal Bruce, Blakely Tony, Swinburn Boyd, Rayner Mike
National Institute for Health Innovation, University of Auckland, Auckland, New Zealand;
National Institute for Health Innovation, University of Auckland, Auckland, New Zealand.
Am J Clin Nutr. 2017 Mar;105(3):695-704. doi: 10.3945/ajcn.116.144956. Epub 2017 Feb 1.
Nutrition labeling is a prominent policy to promote healthy eating. We aimed to evaluate the effects of 2 interpretive nutrition labels compared with a noninterpretive label on consumer food purchases. In this parallel-group randomized controlled trial, we enrolled household shoppers across New Zealand who owned smartphones and were aged ≥18 y. Eligible participants were randomly assigned (1:1:1) to receive either traffic light labels (TLLs), Health Star Rating labels (HSRs), or a control [nutrition information panel (NIP)]. Smartphone technology allowed participants to scan barcodes of packaged foods and to receive allocated labels on their smartphone screens. The primary outcome was the mean healthiness of all packaged food purchases over the 4-wk intervention period, which was measured by using the Food Standards Australia New Zealand Nutrient Profiling Scoring Criterion (NPSC). Between October 2014 and November 2015, 1357 eligible shoppers were randomly assigned to TLL ( = 459), HSR ( = 443), or NIP ( = 455) labels. Overall difference in the mean transformed NPSC score for the TLL group compared with the NIP group was -0.20 (95% CI: -0.94, 0.54; = 0.60). The corresponding difference for HSR compared with NIP was -0.60 (95% CI: -1.35, 0.15; = 0.12). In an exploratory per-protocol analysis of participants who used the labeling intervention more often than average ( = 423, 31%), those who were assigned to TLL and HSR had significantly better NPSC scores [TLL compared with NIP: -1.33 (95% CI: -2.63, -0.04; = 0.04); HSR compared with NIP: -1.70 (95% CI: -2.97, -0.43; = 0.01)]. Shoppers who were randomly assigned to HSR and TLL also found the labels significantly more useful and easy to understand than the NIP (all values <0.001). At the relatively low level of use observed in this trial, interpretive nutrition labels had no significant effect on food purchases. However, shoppers who used interpretive labels found them to be significantly more useful and easy to understand, and compared with frequent NIP users, frequent TLL and HSR users had significantly healthier food purchases. This trial was registered at the Australian New Zealand Clinical Trials Registry (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366446&isReview=true) as ACTRN12614000644662.
营养标签是一项促进健康饮食的重要政策。我们旨在评估两种解释性营养标签与非解释性标签相比对消费者食品购买行为的影响。在这项平行组随机对照试验中，我们招募了新西兰拥有智能手机且年龄≥18岁的家庭购物者。符合条件的参与者被随机分配（1:1:1）接受交通灯标签（TLL）、健康星级评级标签（HSR）或对照组[营养信息面板（NIP）]。智能手机技术使参与者能够扫描包装食品的条形码，并在其智能手机屏幕上接收分配的标签。主要结局是在4周干预期内所有购买的包装食品的平均健康程度，这是通过使用澳大利亚新西兰食品标准营养素分级评分标准（NPSC）来衡量的。在2014年10月至2015年11月期间，1357名符合条件的购物者被随机分配到TLL组（n = 459）、HSR组（n = 443）或NIP组（n = 455）。与NIP组相比，TLL组平均转换后的NPSC评分的总体差异为-0.20（95%CI：-0.94，0.54；P = 0.60）。HSR组与NIP组的相应差异为-0.60（95%CI：-1.35，0.15；P = 0.12）。在一项探索性的符合方案分析中，对于使用标签干预比平均水平更频繁的参与者（n = 423，31%），被分配到TLL和HSR组的参与者的NPSC评分显著更好[TLL组与NIP组相比：-1.33（95%CI：-2.63，-0.04；P = 0.04）；HSR组与NIP组相比：-1.70（95%CI：-2.97，-0.43；P = 0.01）]。被随机分配到HSR和TLL组的购物者也发现这些标签比NIP组显著更有用且更易于理解（所有P值<0.001）。在本试验中观察到的相对较低的使用水平下，解释性营养标签对食品购买没有显著影响。然而，使用解释性标签的购物者发现它们显著更有用且更易于理解，并且与频繁使用NIP的用户相比，频繁使用TLL和HSR的用户购买的食品明显更健康。该试验在澳大利亚新西兰临床试验注册中心（https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366446&isReview=true）注册，注册号为ACTRN12614000644662。
