Attentional capture and understanding of nutrition labelling: a study based on response times

The habitual nature of food purchases at the supermarket: Implications for policy making

Supermarkets have become the most important provider of food products worldwide. However, empirical evidence about how consumers make their food purchase decisions in this environment is still scarce. The present field study aimed to: i) explore how people make their in-store food purchases, and ii) identify the information they search for when making those purchases. Consumers (n = 144) were intercepted when entering the facilities of three supermarkets in two Uruguayan cities. They were asked to wear a mobile eye-tracker while they made their purchases as they normally do. The great majority of the consumers bought at least one food product or beverage (92%) and, on average, examined products from 2.8 sections. In total, they investigated 37 categories within 13 self-service sections, corresponding to 26 categories of ultra-processed products. For 67% of the products, consumers went straight to the product they seemed to be looking for, grabbed it and put it in their shopping basket or cart, without making any comparison among products. A limited information search was observed. On average, consumers spent 22 s examining products within self-service sections and only 6.9 s were elapsed from the moment they grabbed a product until they put it in the shopping cart. These results provide empirical evidence of the habitual nature of supermarket food purchases in a context characterized by wide availability of ultra-processed products. Taken together, the findings suggest that policies and interventions aimed at reducing purchases of ultra-processed products should disrupt habitual decisions at the point of purchase. In this sense, policies targeted at introducing salient changes on food packages hold potential to disrupt food purchases and encourage consumers to establish new and more healthful food purchase habits.

Effectiveness of Different Front-of-Pack Nutrition Labels among Italian Consumers: Results from an Online Randomized Controlled Trial

In Italy, discussions are currently ongoing to implement a front-of-pack nutrition label (FoPL) while a growing number of European countries are adopting the Nutri-Score. The effectiveness of the Nutri-Score among Italian consumers requires further investigation. This study compared five FoPLs among Italian participants (Health Star Rating system, multiple traffic lights, Nutri-Score, reference intakes, warning symbol) in terms of food choices and understanding of the labels by consumers. In 2019, 1032 Italian consumers completed an online survey in which they were asked to select one product they would likely purchase from a set of three foods with different nutrient profiles and then classify the products within the set according to their nutritional quality, first with no label and then with one of the five FoPLs on the pack. While no significant difference across labels was observed for food choices, the Nutri-Score demonstrated the highest overall performance in helping consumers to correctly rank the products according to their nutritional quality compared to the reference intakes (OR = 2.18 (1.50–3.17), p-value < 0.0001). Our results provide new insights on the effectiveness of the Nutri-Score, which would be a relevant tool to inform Italian consumers on the nutritional quality of food products.

"Responses to the Chilean law of food labeling and advertising: exploring knowledge, perceptions and behaviors of mothers of young children"

Background

In line with calls for action from international health organizations, Chile implemented in June 2016 a set of regulations to tackle the obesity epidemic. The new regulation includes the mandatory use of front-of-package warning labels on packaged foods/beverages high in energy, sugars, saturated fats and sodium. Additionally, such foods cannot be sold nor offered in daycares/schools and cannot be promoted to children under 14yo. The law is targeted to children; thus, this study examined mothers’ understanding, perceptions, and behaviors associated with the regulation one year after its implementation, using a qualitative approach.

Methods

Nine focus groups of mothers (7–10 people each) of children (2-14yo) were conducted in July 2017 in Santiago-Chile. They were stratified by socioeconomic status (SES) and children’s age. Macrocodes were developed by three researchers, combining an iterative process of deductive and inductive thematic analyses. Quotations representing each category were selected.

Results

Mothers understood the new regulation as a policy to fight child obesity and were aware that products with more labels were less healthy than products with fewer labels. Attention and use of labels in the buying decision-making process ranged from participants who did not pay attention to others who relied on them as a quick shortcut (mostly from middle and upper-SES); many mothers indicated changing their purchase habits only when buying new products. Mothers declared that young children accepted school environment changes while teens/preteens resisted them more. Many mothers agreed that schools have become key promoters of food behavioral change. Mothers were less aware about the food marketing regulations. Mothers declared that they perceived that the regulation was changing the perceptions, attitudes and behaviors toward healthier eating patterns.

Conclusion

After the first year of implementation, the regulation was well known by mothers of diverse SES and different children ages. The degree of use of warning labels was heterogeneous among participants, but most of them agreed that their children, particularly the youngest have positive attitudes toward the regulation and have become promoters of change in their families. Many mothers also expressed that they perceived an important shift toward healthier eating, which may lead to a change in eating social norms. This information contributes to better understand how regulatory actions may influence people’s consumer behaviors.

Pilot randomized controlled trial testing the influence of front-of-pack sugar warning labels on food demand

Background

Front-of-pack (FOP) nutrition warning labels to identify potentially harmful foods/beverages have recently been considered in Singapore. The objective of this study was to pilot test two promising FOP warning labels intended to reduce purchases of products high in sugar to determine whether a full scale trial testing one or both these labels using actual purchases is warranted.

Methods

Five hundred twelve participants ≥21 years old and residing in Singapore completed all study elements online via the NUSMart Online Grocery Store study website. The study was designed as a Randomized Controlled Trial (RCT) where consumers were randomized and asked to hypothetically shop in one of three versions of an online grocery store; 1) no FOP label (control), 2) a graphical high-in-sugar label shaped like a stop sign, or 3) a text-based warning label. The proportion of labelled products purchased (primary outcome) and all secondary measures of diet quality were calculated using participants’ orders. Ordinary Least Squares (OLS) regression was used to compare purchasing behavior across the three study arms.

Results

The proportion of high-in-sugar products selected (i.e., those targeted for labelling) was largest in the no label control arm at 20%. The proportion was a non-statistically significant 2 percentage points lower (P = 0.146) for the high-in-sugar stop-sign label arm and 4 percentage points lower (P < 0.05) in the warning label with deterrent text arm. We could not reject the hypothesis of equal effectiveness of the two warning labels (P = 0.231).

Conclusions

Results suggest that the two health warning labels have potential to reduce demand for high-in-sugar products in Singapore. Future studies should test the influence of these labels using actual purchases in efforts to identify whether either labelling strategy should be considered for adoption in the local setting.

Trial registration

The American Economic Association’s registry for randomized controlled trials; AEARCTR-0003800. Registered 18 January 2019.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6496-8) contains supplementary material, which is available to authorized users.

A randomized trial assessing the effects of health claims on choice of foods in the presence of front-of-pack labels

Background

As a public health intervention, front-of-pack labels (FoPLs) have the potential to reach large numbers of consumers and promote healthier food choices. Of the different FoPLs, those that summarize a product's overall nutritional profile tend to be most effective in guiding healthier choices. However, information is lacking as to whether FoPLs are as effective when nutrient or health claims also appear on-pack.

Objective

The aim of this study was to examine how the choice of foods of varying levels of healthfulness (less healthy, moderately healthy, and healthier) is affected by the appearance of various FoPLs (Daily Intake Guide, Multiple Traffic Lights, Health Star Rating) when shown in combination with different claim conditions (no claim, nutrient claim, general-level health claim, and higher-level health claim).

Design

Adults and children (n = 2069) completed a discrete-choice experiment online. Respondents were shown 8 choice sets, each containing 4 alternatives of the same food type (cookies, cornflakes, pizza, or yogurt) of varying levels of healthfulness and were asked which product they would likely purchase (or they could select none). Respondents were randomly assigned to view 1 of the 3 FoPLs across all choice sets. Claim type and healthfulness varied within choice sets in accordance with a D-efficient design.

Results

The probability of choosing a healthy product and avoiding an unhealthy product was greatest when only an FoPL (especially the Health Star Rating) appeared on-pack. The addition of a nutrient or health claim did not affect the likelihood of picking healthier products but did increase the likelihood of selecting less healthy foods across all FoPL conditions.

Conclusions

FoPLs are most effective in helping consumers make better food choices when nutrient and health claims are not present. Policies are required to control how nutrient and health claims are applied to less healthy foods. This trial was registered as ACTRN12617000015347 (www.anzctr.org.au/Trial/Resgistration/TrialReview.aspx?id=372055&isReview=true).

The Impact of Front-of-Package Label Design on Consumer Understanding of Nutrient Amounts

A between-groups experiment examined the salience of front-of-package (FOP) symbols. Adults from Canada, the US, Australia, and the UK completed an online survey (n = 11,617). Respondents were randomized to view cereal boxes displaying one of 11 FOP label conditions for 'high' levels of sugar and saturated fat: control (no FOP symbol), red circle, red 'stop sign', magnifying glass, magnifying glass + exclamation mark, and 'caution' triangle + exclamation mark, plus each of these five conditions accompanied by a 'high in' text descriptor. Participants identified the amount of saturated fat and sugar in the product ('low'/'moderate'/'high'). Participants were more likely to correctly identify the product as 'high' in saturated fat or sugar when shown the stop sign, triangle + exclamation mark, red circle, or magnifying glass + exclamation mark symbols incorporating 'high in' text (p < 0.01). The magnifying glass was the least effective symbol. The stop sign (37.7%) and triangle + exclamation mark (22.0%) were most frequently selected as the best symbol for indicating high nutrient amounts. Overall, FOP labels with 'high in' descriptions, red color and intuitive 'warning' symbols (e.g., stop signs, exclamation marks, 'caution' triangles) were more effective at communicating high levels of nutrients of public health concern in a time-limited environment.

The work engagement–performance link: an episodic perspective

Purpose

The purpose of this paper is to integrate job demands–resources theory and the episodic process model to examine the relationships between episodic cognitive mechanisms (i.e. cognitive interference and attentional pull), work engagement and performance. It is hypothesized that an episode characterized by less cognitive interference and more attentional pull (i.e. attraction toward the work activity) is associated with the highest levels of work engagement and job performance. Additionally, it is hypothesized that episodic challenge/hindrance job demands boost/diminish the positive relationship between episodic job resources and work engagement.

Design/methodology/approach

Using experience sampling methodology, 48 employees used their smartphones to complete surveys three times a day for one week, resulting in 266 observations.

Findings

Results of multilevel analyses suggest that episodic hindrance job demands (but not challenge job demands) moderate the positive relation between job resources and work engagement.

Originality/value

This study is unique in that it captures fluctuating cognitive processes (i.e. attentional pull and cognitive interference) that take place during work activities.

Consumers' responses to health claims in the context of other on-pack nutrition information: a systematic review

Context

The presence of health claims on food packaging can positively bias consumers' evaluations of foods. This review examined whether cognitive biases endure when other sources of nutrition information [the nutrition facts panel (NFP) and front-of-pack labels] appear on-pack with health claims. The following databases were searched: Web of Science, Ovid, Google Scholar, ScienceDirect, Scopus, ProQuest, and Wiley Online Library. The search terms ("health claim*" OR "nutri* claim") AND ("food label*" OR "front of pack") were used to identify studies. Twenty-four studies that examined health claims and front-of-pack labels or the NFP were included. The NFP can reduce bias, but only if consumers view it and interpret it correctly, which often does not occur. Front-of-pack labels show greater promise in reducing bias created by health claims. These findings are relevant to policymakers who are considering the effectiveness of mandating an NFP and/or a front-of-pack label alongside health claims.

Can nutritional information modify purchase of ultra-processed products? Results from a simulated online shopping experiment

OBJECTIVE

The aim of the present work was to evaluate the influence of two front-of-pack nutrition information schemes (traffic-light system and Chilean warning system) on consumer purchase of ultra-processed foods in a simulated online grocery store.

DESIGN

Following a between-subjects design, participants completed a simulated weekly food purchase in an online grocery store under one of three experimental conditions: (i) a control condition with no nutrition information, (ii) a traffic-light system and (iii) the Chilean warning system. Information about energy (calories), sugar, saturated fats and salt content was included in the nutrition information schemes.

SETTING

Participants were recruited from a consumer database and a Facebook advertisement.

SUBJECTS

People from Montevideo (Uruguay), aged 18-77 years (n 437; 75 % female), participated in the study. All participants were in charge of food purchase in the household, at least occasionally.

RESULTS

No significant differences between experimental conditions were found in the mean share of ultra-processed foods purchased by participants, both in terms of number of products and expenditure, or in the mean energy, sugar, saturated fat and salt content of the purchased items. However, the Chilean warning system decreased intended purchase of sweets and desserts.

CONCLUSIONS

Results from this online simulation provided little evidence to suggest that the traffic-light system or the Chilean warning system in isolation could be effective in reducing purchase of ultra-processed foods or improving the nutritional composition of the purchased products.

Warnings as a directive front-of-pack nutrition labelling scheme: comparison with the Guideline Daily Amount and traffic-light systems

Objective

Warnings have recently been proposed as a new type of directive front-of-pack (FOP) nutrition labelling scheme to flag products with high content of key nutrients. In the present work, this system was compared with the two most common FOP nutrition labelling schemes (Guideline Daily Amounts (GDA) and traffic-light system) in terms of goal-directed attention, influence on perceived healthfulness and ability to differentiate between products.

Design/Setting/Subjects

Goal-directed attention to FOP labels was evaluated using a visual search task in which participants were presented with labels on a computer screen and were asked to indicate whether labels with high sodium content were present or absent. A survey with 387 participants was also carried out, in which the influence of FOP labels on perceived healthfulness and ability to identify the healthful alternative were evaluated.

Results

Warnings improved consumers’ ability to correctly identify a product with high content of a key nutrient within a set of labels compared with GDA and received the highest goal-directed attention. In addition, products with high energy, saturated fat, sugar and/or sodium content that featured warnings on the label were perceived as less healthful than those featuring the GDA or traffic-light system. Warnings and the traffic-light system performed equally well in the identification of the most healthful product.

Conclusions

Results from the present work suggest that warnings have potential as directive FOP nutrition labels to improve consumer ability to identify unhealthful products and highlight advantages compared with the traffic-light system.

Consumer Perception of the Healthfulness of Ultra-processed Products Featuring Different Front-of-Pack Nutrition Labeling Schemes

OBJECTIVE

To examine the influence of front-of-pack nutrition information on the perception of healthfulness of ultra-processed products across 2 income levels.

DESIGN

A between-participants design was used to compare healthfulness perception of ultra-processed products featuring different front-of-pack nutrition information schemes (guideline daily amount system, traffic light system, and monochromatic traffic light system).

PARTICIPANTS

A total of 300 people (aged 18-70 years, 75% female) from Montevideo, Uruguay, participated in the study; half were middle- or high-income people and the other half were low-income people.

MAIN OUTCOME MEASURES

Participants were shown the labels of each product and asked to rate their perceived healthfulness and the frequency with which each product should be consumed.

ANALYSIS

Results were analyzed using analysis of variance for statistical significance (P < .05).

RESULTS

Low-income participants perceived ultra-processed products to be significantly (P < .05) more healthful than did middle- and high-income participants. The lowest perceived healthfulness scores for low-income participants were obtained for products featuring the colored and monochromatic traffic light system whereas no significant differences (P > .05) among schemes were found for middle- and high-income participants.

CONCLUSIONS AND IMPLICATIONS

Nutrition education programs aimed at increasing low-income people's knowledge of the nutritional composition of these products and their potential negative effects on health seem to be necessary. Although the inclusion of semidirective front-of-pack nutrition information decreased the perceived healthfulness of low-income people, it seemed unlikely to influence how they perceive these products.

Benchmarks and Blinders: How Canadian Women Utilize the Nutrition Facts Table

PURPOSE

To better understand how consumers use the Nutrition Facts Table (NFT) in their everyday shopping decisions and food consumption habits.

METHODS

Thirteen Canadian females were interviewed about how they use the NFT in their food choices.

RESULTS

Different elements of the front of the package served different purposes. Health claims and health checks drew attention to the product, but were not highly trusted. Ingredient lists were used to find "real food." NFTs were considered important with each participant reporting an individualized strategy for using the NFT characterized by the application of benchmarks and blinders. The term "blinders" reflected only seeing and using one specific nutrient by assessing whether or not it exceeded a certain "benchmark" established by the participant. Therefore, the level of one specific nutrient determined the healthfulness of the product and the subsequent purchase/consumption decision.

CONCLUSIONS

Findings suggest that NFTs should be redesigned. Some ideas for redesign include only listing "unhealthy" nutrients, having serving sizes more congruent to what is eaten in a typical sitting, making it easier to identify when a food may be high in a nutrient, and providing ways to allow the NFT to be used to meet personal, individualized needs.

The efficacy of calorie labelling formats on pre-packaged foods: An experimental study among adolescents and young adults in Canada

OBJECTIVES

Several countries have proposed changes to calorie labelling on nutrition facts tables (NFTs) on pre-packaged foods. As most research to date has examined general use of NFTs, there is a lack of evidence to guide specific design changes to calorie information on labels. This study examined the efficacy of various calorie labelling formats on recall, comprehension, and consumer preferences for calorie information.

METHODS

Experiments were conducted as part of an online survey with a national sample of 2,008 Canadians aged 16-24. In Task 1, participants were shown one of six labelling formats (e.g., %DV, Traffic Light) with calories in either small or large font, and asked to recall the amount of calories. Task 2 examined comprehension of calories in the context of recommended daily intake (RDI), using the same NFT as in Task 1. Task 3 identified participants' preferences for labelling formats.

RESULTS

NFTs with calories in large font enhanced calorie recall (p &lt; 0.001). When small font was displayed, the Traffic Light format performed best at improving recall (p &lt; 0.01). With large font, the highest recall was in the Current, RDI and Traffic Light formats (all p &lt; 0.05). Comprehension of servings per RDI was highest in the Infographic format, with no difference by font size (p &lt; 0.001). Respondents preferred the large font calorie condition and the Infographic format (p &lt; 0.001).

CONCLUSIONS

Enhancements in visibility and design can improve the efficacy of calorie labelling on pre-packaged foods. The findings have direct implication for proposed changes to calorie labelling on NFTs in Canada and the United States.

Influence of Interpretation Aids on Attentional Capture, Visual Processing, and Understanding of Front-of-Package Nutrition Labels

OBJECTIVE

To study the influence of 2 interpretational aids of front-of-package (FOP) nutrition labels (color code and text descriptors) on attentional capture and consumers' understanding of nutritional information.

DESIGN

A full factorial design was used to assess the influence of color code and text descriptors using visual search and eye tracking.

PARTICIPANTS

Ten trained assessors participated in the visual search study and 54 consumers completed the eye-tracking study.

MAIN OUTCOME MEASURES

In the visual search study, assessors were asked to indicate whether there was a label high in fat within sets of mayonnaise labels with different FOP labels. In the eye-tracking study, assessors answered a set of questions about the nutritional content of labels.

ANALYSIS

The researchers used logistic regression to evaluate the influence of interpretational aids of FOP nutrition labels on the percentage of correct answers. Analyses of variance were used to evaluate the influence of the studied variables on attentional measures and participants' response times.

RESULTS

Response times were significantly higher for monochromatic FOP labels compared with color-coded ones (3,225 vs 964 ms; P < .001), which suggests that color codes increase attentional capture. The highest number and duration of fixations and visits were recorded on labels that did not include color codes or text descriptors (P < .05). The lowest percentage of incorrect answers was observed when the nutrient level was indicated using color code and text descriptors (P < .05).

CONCLUSIONS AND IMPLICATIONS

The combination of color codes and text descriptors seems to be the most effective alternative to increase attentional capture and understanding of nutritional information.