Mantzari Eleni, Vasiljevic Milica, Turney Isabelle, Pilling Mark, Marteau Theresa
Behaviour and Health Research Unit, University of Cambridge, UK.
Department of Psychology, University of Cambridge, UK.
Prev Med Rep. 2018 Oct 23;12:259-267. doi: 10.1016/j.pmedr.2018.10.016. eCollection 2018 Dec.
Sugar-sweetened beverages (SSBs) are one of the largest added sugar sources to diets in the UK and USA, particularly among young people. Warning labels, including calorie information labels, could reduce SSB consumption but uncertainty surrounds the labels that are most effective. This study assessed the impact of labels containing (a) each of two image-based warnings and (b) calorie information, singly and together, on SSB selection by parents of 11-16-year-olds living in the UK. Using a 3 (disease image, sugar content image, no image) × 2 (calorie information, no calorie information) between-subjects experimental design, 2002 participants were randomised to see beverages with one of six labels and selected one for their child to consume. The primary outcome was the proportion of participants selecting an SSB. Data were collected in December 2017. Logistic regressions showed SSB selection was lower when labels contained an image-based warning (35%), compared to not having any label (49%) or just calorie information (43.5%). The disease image lowered selection more than the sugar image (32% vs 40.5%). Providing calorie information with the disease image had no additional impact on selection (33%) but enhanced the impact of the sugar image (36%). Image-based warning labels discourage SSB selection by parents for their children. Images depicting health consequences of excess sugar consumption have larger effects than those depicting sugar content. Calorie information does not add to the effect of the former but does to that of the latter. Field studies are needed to assess the impact of SSB warning labels in real-life settings.
含糖饮料（SSB）是英国和美国饮食中添加糖的最大来源之一，在年轻人中尤为如此。包括卡路里信息标签在内的警告标签可能会减少含糖饮料的消费，但最有效的标签仍存在不确定性。本研究评估了包含（a）两种基于图像的警告中的每一种以及（b）卡路里信息的标签单独和共同对居住在英国的11至16岁青少年父母选择含糖饮料的影响。采用3（疾病图像、糖含量图像、无图像）×2（卡路里信息、无卡路里信息）组间实验设计，将2002名参与者随机分组，观看六种标签之一的饮料，并为其孩子选择一种饮用。主要结果是选择含糖饮料的参与者比例。数据于2017年12月收集。逻辑回归显示，与没有任何标签（49%）或只有卡路里信息（43.5%）相比，当标签包含基于图像的警告时，含糖饮料的选择率较低（35%）。疾病图像比糖图像更能降低选择率（32%对40.5%）。将卡路里信息与疾病图像一起提供对选择没有额外影响（33%），但增强了糖图像的影响（36%）。基于图像的警告标签会使父母为孩子选择含糖饮料的意愿降低。描绘过量摄入糖的健康后果的图像比描绘糖含量的图像影响更大。卡路里信息不会增加前者的效果，但会增加后者的效果。需要进行实地研究来评估含糖饮料警告标签在现实生活中的影响。
