School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Department of Health Behavior, Gillings School of Global Public Health, and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
J Nutr. 2022 Jun 13;152(Suppl 1):13S-24S. doi: 10.1093/jn/nxac018.
Nutrition labels on prepackaged foods are an important source of nutrition information; however, differences in comprehension of varying label formats can limit their use and effectiveness.
This study examined levels and correlates of consumers' self-reported understanding of Nutrition Facts tables (NFts) and front-of-package (FOP) labels, as well as functional NFt understanding.
Adults (≥18 y) in Australia (n = 3901), Canada (n = 4107), Mexico (n = 4012), the United Kingdom (n = 5121), and the United States (n = 4445) completed online surveys in November/December 2018. Descriptive statistics summarized sample profiles by country. Linear regression models examined the association between label understanding (self-reported NFt and FOP, functional NFt) and consumer dietary behaviors, functional nutrition knowledge, and sociodemographic characteristics. NFt understanding was measured in all countries, with FOP labeling assessed only in Mexico, Australia, and the United Kingdom.
Self-reported and functional NFt understanding was significantly higher in the United States and Canada (P < 0.0001). In adjusted analyses, functional NFt understanding was significantly higher among women compared to men (P < 0.0001); respondents from the "majority" ethnic group in their respective countries compared with minority ethnic groups (P < 0.0001); those with higher education levels (P < 0.0001) and functional nutrition knowledge compared with their lower education and nutrition knowledge counterparts (P < 0.0001), respectively; and those making efforts to consume less sodium, sugar, or fat compared with those not reporting dietary efforts (P < 0.0001). Self-reported FOP label understanding was significantly higher for interpretive labeling systems in Australia (health star ratings) and the United Kingdom (traffic lights) compared with Mexico's Guideline Daily Amounts (GDAs) (P < 0.0001).
Nutrition labels requiring greater numeracy skills (i.e., NFts, GDAs) were more difficult for consumers to understand than interpretive FOP labels (i.e., traffic lights). Differences in NFt and FOP label understanding by income adequacy and education suggest potential disparities in labeling policy effects among vulnerable subgroups.
预包装食品上的营养标签是营养信息的重要来源；然而，对各种标签格式的理解程度存在差异，这可能会限制其使用和有效性。
本研究调查了消费者自我报告的对营养成分表（NFts）和包装正面（FOP）标签的理解水平和相关因素，以及对 NFt 的功能理解。
2018 年 11 月至 12 月，澳大利亚（n=3901）、加拿大（n=4107）、墨西哥（n=4012）、英国（n=5121）和美国（n=4445）的成年人（≥18 岁）完成了在线调查。描述性统计数据按国家总结了样本特征。线性回归模型分析了标签理解（自我报告的 NFt 和 FOP、NFt 的功能）与消费者饮食行为、功能性营养知识和社会人口统计学特征之间的关系。所有国家都测量了 NFt 的理解，仅在墨西哥、澳大利亚和英国评估了 FOP 标签。
自我报告和 NFt 的功能理解在美国和加拿大显著更高（P<0.0001）。在调整后的分析中，与男性相比，女性的 NFt 功能理解显著更高（P<0.0001）；与少数族裔相比，各自国家的“多数”族裔受访者（P<0.0001）；与教育程度较低的受访者相比，教育程度较高的受访者（P<0.0001）和功能性营养知识较高的受访者（P<0.0001）；与不报告饮食努力的受访者相比，努力减少钠、糖或脂肪摄入的受访者（P<0.0001）。与墨西哥的日摄入量指南（GDAs）相比，澳大利亚（健康星级评级）和英国（交通灯）的解释性 FOP 标签理解（解释性 FOP 标签理解）对于解释性标签系统更高（P<0.0001）。
需要更多计算技能的营养标签（即 NFts、GDAs）比解释性 FOP 标签（即交通灯）更难被消费者理解。NFt 和 FOP 标签理解程度因收入充足程度和教育程度而异，这表明弱势群体在标签政策效果方面可能存在差异。
