Andreeva Valentina A, Egnell Manon, Handjieva-Darlenska Teodora, Talati Zenobia, Touvier Mathilde, Galan Pilar, Hercberg Serge, Pettigrew Simone, Julia Chantal
Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University/INSERM U1153/INRAE U1125/CNAM), Epidemiology and Statistics Research Centre - University of Paris (CRESS), 74 rue Marcel Cachin, 93017 Bobigny, France.
Department of Pharmacology and Toxicology, Medical University, 1431 Sofia, Bulgaria.
Arch Public Health. 2020 Jun 9;78:35. doi: 10.1186/s13690-020-00416-z. eCollection 2020.
Bulgaria continues to lag behind other EU Member States with respect to chronic disease morbidity and mortality prevention.
In line with efforts targeting the improvement of dietary practices, this comparative study assessed objective understanding of five different front-of-package labels (FOPL) (Reference Intakes, Multiple Traffic Lights, Warning label, Nutri-Score, and Health Star Rating) in a sample of 1010 Bulgarian adults. Objective understanding was assessed by comparing the results of two nutritional quality ranking tasks (with and without FOPL) in an online randomized experiment featuring three food categories (pizza, cakes, breakfast cereals). Multivariable ordinal logistic regression models within and across food categories were fit.
Compared with the Reference Intakes group, participants randomized to Nutri-Score exhibited the largest improvement in product ranking ability across food categories (OR = 2.33; 95% CI: 1.55-3.51), followed by those randomized to Health Star Rating (OR = 1.99; 95% CI: 1.32-3.00). Nutri-Score also performed best within two (pizza and breakfast cereals) of the three food categories. The Multiple Traffic Lights and Warning label groups did not display any significant improvement in objective understanding either within or across food categories compared with the Reference Intakes group.
Nutri-Score, which is a summary, interpretive, polychromatic FOPL, emerged as the most effective model in the Bulgarian context, with the potential to help consumers better understand the nutritional quality of food. The findings are of particular interest to public health policymakers in the region and across Europe, as the debate about an EU-wide FOPL model continues to gather momentum.
Registration number ACTRN12618001221246. Trial registered at the Australian New Zealand Clinical Trials Registry.
保加利亚在慢性病发病率和死亡率预防方面继续落后于其他欧盟成员国。
为配合改善饮食习惯的努力，这项比较研究评估了1010名保加利亚成年人样本对五种不同的包装正面标签（FOPL）（参考摄入量、多重红绿灯、警告标签、营养评分和健康星级评定）的客观理解。通过在一项在线随机实验中比较两项营养质量排名任务（有和没有FOPL）的结果来评估客观理解，该实验涉及三类食品（披萨、蛋糕、早餐谷物）。对食品类别内部和之间的多变量有序逻辑回归模型进行了拟合。
与参考摄入量组相比，随机分配到营养评分组的参与者在各类食品的产品排名能力方面表现出最大的改善（OR = 2.33；95% CI：1.55 - 3.51），其次是随机分配到健康星级评定组的参与者（OR = 1.99；95% CI：1.32 - 3.00）。营养评分在三类食品中的两类（披萨和早餐谷物）中也表现最佳。与参考摄入量组相比，多重红绿灯和警告标签组在食品类别内部或之间的客观理解方面均未显示出任何显著改善。
营养评分作为一种总结性、解释性、多色的包装正面标签，在保加利亚的背景下成为最有效的模型，有可能帮助消费者更好地理解食品的营养质量。随着关于全欧盟范围的包装正面标签模型的辩论继续升温，这些发现对该地区和整个欧洲的公共卫生政策制定者特别有意义。
注册号ACTRN12618001221246。该试验在澳大利亚新西兰临床试验注册中心注册。
