Guilt and the Consumption of Products with an Unhealthy Image

The purpose of this study was to investigate the effects of nutrition labeling on consumers’ guilt when they consumed products with an unhealthy image. The first investigation was conducted to examine direct effect according to the types of nutrition labeling (adding healthy ingredients/reducing unhealthy ingredients) by independent samples t-test. The findings show that consumers felt less guilty when the number of unhealthy ingredients was reduced, compared to when healthy ingredients were added. The second investigation tested the effects of goal activation types (utilitarian/hedonic) and nutrition labeling on consumers’ guilt by independent samples t-test and ANOVA. Goal activation was added as an independent variable, and hypothetical scenarios and stimulants were used. The experiment was designed with a focus on goal activation (utilitarian/hedonic) × nutrition labeling (adding healthy ingredient/reducing unhealthy ingredient). The findings reveal that the utilitarian goal activation group felt less guilty about the products with the reduction in the number of unhealthy ingredients than the products with the addition of healthy ingredients. The hedonic goal activation group felt less guilty about the products with the addition of positive nutrients compared to the products with the reduction in the number of negative nutrients. The third investigation tested consumer guilt in situations that create anxiety about food by independent samples t-test and ANOVA, based on Study 2. Unlike in Study 2, there was no interaction effect between product-nutrition labelling and goal activation. These results suggest that, when consumer anxiety increases, in relation to unhealthy foods that already invoke guilt and anxiety, the motivation—namely, goal activation when consuming food—plays a main role in causing anxiety, regardless of nutrition. Based on these experimental results, the investigator discussed the academic and practical implications of the present study. Finally, a couple of proposals were made for the direction of future study.

Impact of color-coded and warning nutrition labelling schemes: A systematic review and network meta-analysis

Background Suboptimal diets are a leading risk factor for death and disability. Nutrition labelling is a potential method to encourage consumers to improve dietary behaviour. This systematic review and network meta-analysis (NMA) summarises evidence on the impact of colour-coded interpretive labels and warning labels on changing consumers’ purchasing behaviour. Methods and findings We conducted a literature review of peer-reviewed articles published between 1 January 1990 and 24 May 2021 in PubMed, Embase via Ovid, Cochrane Central Register of Controlled Trials, and SCOPUS. Randomised controlled trials (RCTs) and quasi-experimental studies were included for the primary outcomes (measures of changes in consumers’ purchasing and consuming behaviour). A frequentist NMA method was applied to pool the results. A total of 156 studies (including 101 RCTs and 55 non-RCTs) nested in 138 articles were incorporated into the systematic review, of which 134 studies in 120 articles were eligible for meta-analysis. We found that the traffic light labelling system (TLS), nutrient warning (NW), and health warning (HW) were associated with an increased probability of selecting more healthful products (odds ratios [ORs] and 95% confidence intervals [CIs]: TLS, 1.5 [1.2, 1.87]; NW, 3.61 [2.82, 4.63]; HW, 1.65 [1.32, 2.06]). Nutri-Score (NS) and warning labels appeared effective in reducing consumers’ probability of selecting less healthful products (NS, 0.66 [0.53, 0.82]; NW,0.65 [0.54, 0.77]; HW,0.64 [0.53, 0.76]). NS and NW were associated with an increased overall healthfulness (healthfulness ratings of products purchased using models such as FSAm-NPS/HCSP) by 7.9% and 26%, respectively. TLS, NS, and NW were associated with a reduced energy (total energy: TLS, −6.5%; NS, −6%; NW, −12.9%; energy per 100 g/ml: TLS, −3%; NS, −3.5%; NW, −3.8%), sodium (total sodium/salt: TLS, −6.4%; sodium/salt per 100 g/ml: NS: −7.8%), fat (total fat: NS, −15.7%; fat per 100 g/ml: TLS: −2.6%; NS: −3.2%), and total saturated fat (TLS, −12.9%; NS: −17.1%; NW: −16.3%) content of purchases. The impact of TLS, NS, and NW on purchasing behaviour could be explained by improved understanding of the nutrition information, which further elicits negative perception towards unhealthful products or positive attitudes towards healthful foods. Comparisons across label types suggested that colour-coded labels performed better in nudging consumers towards the purchase of more healthful products (NS versus NW: 1.51 [1.08, 2.11]), while warning labels have the advantage in discouraging unhealthful purchasing behaviour (NW versus TLS: 0.81 [0.67, 0.98]; HW versus TLS: 0.8 [0.63, 1]). Study limitations included high heterogeneity and inconsistency in the comparisons across different label types, limited number of real-world studies (95% were laboratory studies), and lack of long-term impact assessments. Conclusions Our systematic review provided comprehensive evidence for the impact of colour-coded labels and warnings in nudging consumers’ purchasing behaviour towards more healthful products and the underlying psychological mechanism of behavioural change. Each type of label had different attributes, which should be taken into consideration when making front-of-package nutrition labelling (FOPL) policies according to local contexts. Our study supported mandatory front-of-pack labelling policies in directing consumers’ choice and encouraging the food industry to reformulate their products. Protocol registry PROSPERO (CRD42020161877).

Impact of Varied Menu Nutrition Labelling Formats on Consumer Food Selections using FAFH

The adoption of menu labelling in restaurant menus is a sporadic but constructive pursuit worldwide. The aim of this study was to investigate the impact of varied menu labelling formats on consumer food acceptance alongside the consumer’s knowledge about nutrition hitherto.162 adults aged 18–40 were distributed among the three menu classification settings: (1) No labelling; (2) kilocalorie labelling; (3) kilocalorie, total fat and free sugars with TLS (Traffic light system) labelling. Participants were offered with their allocated menu online via goggle forms and instructed to select two starters as they would at any restaurant. Followed by this, the participants were exposed to all the three menu labelling conditions simultaneously and were asked to select any one of the three menu category formats which they would prefer to see at restaurants. The variances in the macronutrient content of the starters selected by the participant’s as per the allocated menu classification condition were analysed using one way ANOVA. Legislatively mandated menu labelling schemes at food and beverage establishments needs to be emphasized and enforced politically, to function as prime drivers of public health action in foreseeable future.

232The Impact of Australasian Voluntary Front of Pack Nutrition Labelling on Packaged Food Reformulation

Background Front-of-pack nutrition labelling (FoPL) of packaged foods can promote healthier diets. Australia & New Zealand (NZ) adopted the voluntary Health Star Rating (HSR) scheme in 2014. We studied the impact of voluntary adoption of HSR on food reformulation overall, and for more- versus less-healthy foods. Methods Annual nutrition information panel data was collected for non-seasonal packaged foods sold in major supermarkets in Auckland from 2013-19, and Sydney from 2014-18. We used difference-in-differences to estimate reformulation associated with HSR adoption. Results Healthier products adopted HSR more than unhealthy products: 35% of products that achieved four or more stars displayed the label compared to 15% of products that achieved two stars or less. Products that adopted HSR were 6.5% & 10.7% more likely to increase their rating by ≥ 0.5 stars in Australia and NZ, respectively. Labelled products showed a -4.2% [95% CI -6.5% to -1.9%] relative decline in sodium content in NZ, but there was no sodium change in Australia. There was a -2.3% [-3.7% to -1.0 %] change in sugar content in NZ and a -1.1% [-2.2% to 0.0%] difference in Australia. Initially unhealthy products showed larger reformulation when adopting HSR than healthier products. Conclusions Overall, introduction of HSR had a small effect on product reformulation. The voluntary nature of the HSR program lowers effectiveness because labels were mostly placed on already healthy products. These already healthy products had limited scope for reformulation. Key messages HSR adoption by unhealthy products should be incentivized, or mandated, by governments to maximise reformulation

Analysis of the policy process for the implementation of nutritional warning labels in Uruguay

Objective: To analyse the process for the development and implementation of mandatory nutritional warning labels in Uruguay, in order to inform future nutrition policy making and strategic engagement by public health actors. Design: The study design drew on policy analysis methodology and case study research methodology. Two main sources of information were selected and analysed for the current study: eighteen official documents from the Uruguayan government and 259 news reports, published between June 2017 and February 2021. Setting: Uruguay, Latin America. Results: The Uruguayan Ministry of Public Health led a cross-sectoral working group composed of diverse governmental stakeholders, international organisations and the academia to develop the front-of-package nutrition labelling policy. A robust evidence-based approach, based on rigorous scientific knowledge generated in the country, was followed. However, changes in the systemic governing coalition as a consequence of a change in government led to a delay in the entry into force and changes in the regulation. The food industry was the main opponent to the warning label regulation and relied on widely reported corporate political activities to influence the policy process: information and messaging, legal action, policy substitution, opposition, fragmentation and destabilisation. Conclusions: Key insights to inform future policy action in Uruguay and other jurisdictions were derived. Results stressed the importance of an evidence-based approach for policy design and the early engagement with actors from all the political system.

Evaluation of the Ability of Nutri-Score to Discriminate the Nutritional Quality of Prepacked Foods Using a Sale-Weighting Approach

The implementation of mandatory front-of-pack nutrition labelling is currently being discussed in the European Union (EU). The Nutri-Score (NS) was developed in France to empower consumers to make informed and healthier food choices. Based on strong evidence of its efficacy in supporting healthy choices, it has already been implemented for voluntary use in some EU member states, making it relevant to developing a harmonised EU scheme. This study aimed to evaluate the NS’s discriminating ability on products available in the food supply and compare it with Slovenian national nutritional recommendations based on an adapted WHO Europe (WHOE) profile. The innovative approach of the study is that we used sale-weighting to address the public health importance of available foods, with consideration of market share. We profiled 15,822 products available in the Slovenian food supply in 2017. The NS had a high ability to discriminate food products based on nutritional composition. Products that are generally encouraged in dietary recommendations (fruits, vegetables, cereals) had, in most cases, better NS grades than less favourable products (confectionery, snack foods, added fats), which is also in line with the national nutrition policy programme. The discriminating ability of the model was also shown within food (sub)categories (e.g., plain and flavoured yoghurt). Sale-weighting showed that offerings do not always reflect sales. Major differences between offerings and sales were observed for beverages, dairy, fruits/vegetables, and edible oils/emulsions. Additionally, sale-weighted distribution tended towards less favourable nutritional composition, particularly in categories with overall smaller offerings of products with favourable composition. The NS showed moderate agreement with the WHOE profile (κ = 0.57); differences were particularly observed in flavoured yoghurts, juices, cooking oils, and cheeses. Modelling the operation of the NS with representative real-life food samples provided insight valuable for developing and implementing harmonised mandatory front-of-pack nutrition labelling in Europe.

SOCIAL RESPONSIBILITY IN FOOD INDUSTRY

There are many different front-of-pack nutrition labels and there is not yet established a convergence. Governments and manufacturers try to provide more nutritional information on food labels. The analysis covered the period between 1980 and 2021. This study increases the attention of all stakeholders involved in the front-of-pack nutrition labelling debate. In this regard is relevant to present the advantages and disadvantages, the similarities and the differences of front-of-pack nutrition labelling, because each one is unique, so it is hard to compare them by using the same criteria. The paper brings into the spotlights different policies from different countries that aim to educate the consumers about the content of food, the case of front-of-pack food labeling, that represents a social responsibility issue, especially for health and obesity prevention, noncommunicable diseases, cardiovascular diseases, cancer, diabetes, due to the important role played. Our results show that there are key items, in terms of social responsibility, companies should take into account when planning their strategies and may help also the investors in food manufacturing companies with an increased interest in social information to request and understand the importance of the front-of-pack nutrition labelling of companies they want to invest in. Our research is important for the business to advance in disclosure on the pack of food of relevant information, as well for the academic community regarding the front-of-pack nutrition labelling, as a responsibility issue. Future research is needed since there is a variety of front-of-pack nutrition labelling and is changing constantly.