Only the best for my kids: An extended TPB model to understand mothers' use of food labels

Despite the evidence that mothers' food purchasing behavior impacts the quality of children's diet, few studies have explored psycho-social factors influencing how mothers choose the food to buy for their children. To fill this gap, this study tested an extended Theory of Planned Behavior (TPB) model to predict mothers' tendency to seek information on food labels before purchasing food for children. Participants included 311 Italian mothers who completed a self-report questionnaire measuring their information-seeking behavior, TPB variables, anticipated regret and healthy-eater identity. Results from a Multiple Correspondence Analysis showed that mothers' information-seeking behavior involved a continuum of choices ranging from selecting conventional or prepackaged foods to choosing to read the food label before making a purchase. Besides, a Partial Least Squares-Structural Equation Modeling analysis showed that information-seeking behavior was positively predicted by intention (β = 0.309, p < 0.001) and healthy-eater identity (β = 0.195, p < 0.001). In turn, intention was positively affected by attitude (β = 0.208, p < 0.001), subjective norms (β = 0.155, p < 0.01), perceived behavioral control (β = 0.124, p < 0.05), anticipated regret (β = 0.193, p < 0.001), and healthy-eater identity (β = 0.191, p < 0.001). These findings emphasize that future initiatives could usefully target attitude, anticipated regret and self-identity to encourage mothers' informed food choices for their children.

A cross-section from the consumer perspective on sustainable nutrition: consumer awareness and motivation status

Sustainable diets and food production systems are important for healthy life and future generations. This goal should be reachable by consumer motivations. The study aim is the evaluation of awareness and knowledge of sustainability and logo/claims related with sustainability.Participants' knowledge about sustainability definition and logos/claims related to sustainability were assessed by an online-questionnaire. The questionnaire involved the calculation of annual dietary carbon emissions (kg), nitrogen waste (g), and water consumption (L).Four hundred-two volunteers participated in the study (male: 24.9%; female: 75.1). Only 44 participants (10.9%) explained what sustainable nutrition definition, correctly. The rates of knowledge about logos were quite low; 29.4% for organic product logo; 26.6% for Good farming practice logo; 86.1% for Recycle logo; and 8.0% for Eco-label logo, respectively. The education status of participants affected to knowledge of logo/claim ratio (p < 0.05). Ethic production and environmental impact statement information were care of participants' ratio of 33.6% and 34.1%, respectively. The mean dietary carbon emission of participants was 551.0 ± 343.6 kg/year, which was 81% of the upper limit (680 kg/year). The mean nitrogen waste was 3238.8 ± 4620.9 g/year and mean water consumption was 91,538.7 ± 157,537.9 L/year. Mediterranean diet model carbon emission and nitrogen waste were higher than other diet models, omnivore diet models had more water consumption than other diet models. But these differences were not found statistically significant (p > 0.05).Sustainable nutrition can be achieved via consumers' awareness. Food industry and government should encourage the people about promotion of sustainable food preferences.

The importance of front-of-pack labels in improving health status and eating behavior

The aim of this Editorial is to give an overview on the multiple aspects of front-of-pack labels (FOPLs) and provide the readers a balanced view of the problems raised in this research field, placing them in a wider context. Furthermore, this editorial paper discusses whether and how the use of FOPLs can promote health status in relation to the individual eating pattern and which should be the next research scenarios to investigate to further improve and integrate these tools.

Nutritional quality of prepackaged foods carrying health or nutritional claims in KSA

Objectives

To evaluate the nutritional quality of products carrying health or nutritional claims to protect consumers from being misled and to ensure that they are provided with accurate information about food products that are associated with health or nutritional claims.

Methods

This was a cross-sectional survey of 1153 foods that were randomly sampled from 14 stores in Riyadh, KSA. The data were collected from nutritional facts presented on food labels and evaluated by comparing the mean level of nutrients between products that featured claims and those that did not use the UK nutrient profile model (UKNPM).

Results

Overall, 29% of products carried either health or nutritional claims. Only 19.2% of foods that carried health claims met Saudi Food and Drug Authority (SFDA) requirements, while 28.9% of all products that carried nutritional claims met SFDA criteria; however, the analysis indicated that products that carried health or nutritional claims were significantly lower in sugar (9.67 g/100 g), fat (9.2 g/100 g), saturated fat (3.2 g/100 g), and sodium (371.36 mg/100 g). According to the UKNPM, 46.9% of the products carrying claims were less healthy than those not carrying claims, and statistically significant differences were observed by product origin and category (p < 0.005 and p < 0.000, respectively).

Conclusion

The current representation of unregulated claims on food products may mislead the consumer. There is an urgent need for government legislation that limits their use except under certain conditions for the optimal protection of the population's health.

Does labelling a food as 'light' vs. 'filling' influence intake and sensory-specific satiation?

Although several studies have investigated the influence of nutrition labelling on food intake, the effect of labels indicating a food's satiating power on food intake and sensory-specific satiation (SSS) is poorly understood. We investigated whether providing information about the satiating power of a meal affects intake and SSS. Participants (19 men and 18 women) consumed the same test meal of pasta salad ad libitum on two occasions, once described as 'light' and once as 'filling'. SSS was determined as the change in liking of the flavor and desire to eat the test meal before and after consumption, compared to seven uneaten foods. As hypothesized, intake increased by a mean (±SD) of 31 ± 59 g and 42 ± 81 kcal when the meal was labelled 'light' as opposed to 'filling' (p < 0.01). After eating, ratings for both liking and desire to eat decreased significantly more for the test meal than for the uneaten control foods (p < 0.001), demonstrating SSS. These relative changes in liking and desire to eat did not differ between the label conditions, despite differences in intake. Furthermore, accounting for amount consumed, the magnitude of SSS did not differ between the label conditions, which suggests that it did not explain the effect of the labels on intake. This study shows that labels indicating the satiating power of a meal can affect intake, warranting caution in the use of such labels on products intended to reduce intake.

Trends in the adherence to the Mediterranean diet in Israeli adolescents: results from two national health and nutrition surveys, 2003 and 2016

PURPOSE

To compare the adherence to the Mediterranean diet (MD) in Israeli adolescents in 2003-4 and in 2015-6, and associated factors.

METHODS

Adolescents (aged 11-19 years) from two cross-sectional, school-based, nationally representative surveys, Mabat Youth I (2003-4, n 5005) and II (2015-6, n 3906), completed self-administered questionnaires on food frequency, eating behaviors and lifestyle. The Mediterranean Diet Quality Index for Children and Adolescents (KIDMED index), derived from these questionnaires, was used; higher scores indicate better diet quality. The samples comprised eight subgroups, according to population group (Jews/Arabs), school level (middle/high) and sex.

RESULTS

The percentages with poor, average and good KIDMED scores were 11.6, 45.3 and 43.1% in 2015-6, compared to 25.5, 55.2 and 19.3%, respectively, in 2003-4. Significant improvement was seen in all subgroups (all p < 0.001), and was attributed to increased consumption of fruits, vegetables, cereals, dairy products, and decreased negative eating behaviors. In Mabat Youth II, physical activity at least 1 h/day was positively associated with good KIDMED scores among Jewish adolescents; dieting and sleeping at least 7 h/day were associated with good MD adherence in Jewish boys; always/often reading food labels predicted good MD adherence among Jewish boys and Arab girls. Overweight and obesity were negatively associated with better KIDMED scores in Jewish boys.

CONCLUSION

MD adherence in Israeli adolescents has improved overall. The changes in MD components and the associated behavioral factors indicate the initiatives, relevant to the different subgroups, that are necessary to promote healthier nutrition and lifestyles.

Front-Of-Pack Nutrition Labelling: A Position Statement of the European Academy of Paediatrics and the European Childhood Obesity Group

BACKGROUND

Due to the growing risk of obesity and related diseases in the population of children, effective preventive measures are of great importance. Front-of-pack (FOP) nutrition labelling may contribute to health promotion by increasing consumer awareness on the nutritional qualities of packaged foods and purchasing decisions, and it may stimulate food providers to improve the composition of products.

SUMMARY

Appropriate labelling should enable customers to make healthy choices quickly and intuitively. Key Messages: The European Academy of Paediatrics and the European Childhood Obesity Group makes an appeal to European Union legislators to immediately introduce a mandatory, uniform, and interpretative FOP nutrition labelling system.

"I'll try the veggie burger": Increasing purchases of sustainable foods with information about sustainability and taste

Food production--especially raising animals for meat--has a massive negative impact on the environment and contributes to global warming. To address this, we investigated whether information about food sustainability would increase purchases of sustainable foods by patrons of university cafés. In Study 1, patrons were randomly assigned either to see a menu that had sustainability labels indicating the degree of environmental impact of each item, or to see a menu without labels. Women who saw the labels were significantly more likely to purchase sustainable foods, whereas men were not influenced by the labels. In Study 2 we targeted one sustainable menu item (a veggie burger) and, in a 2 (sustainability) x 2 (taste) design, varied whether patrons learned that the veggie burger was especially sustainable or especially tasty. Women were significantly more likely to purchase the veggie burger if they learned it was sustainable or tasty, but again, the manipulations had no effect on men. We discuss why women are more likely to change their food choices to eat more sustainably than are men.

Consumer confusion about wholegrain content and healthfulness in product labels: a discrete choice experiment and comprehension assessment

OBJECTIVE

Using a legal standard for scrutinising the regulation of food label claims, this study assessed whether consumers are misled about wholegrain (WG) content and product healthfulness based on common product labels.

DESIGN

First, a discrete choice experiment used pairs of hypothetical products with different amounts of WG, sugar and salt to measure effects on assessment of healthfulness; and second, a WG content comprehension assessment used actual product labels to assess respondent understanding.

SETTING

Online national panel survey.

PARTICIPANTS

For a representative sample of US adults (n 1030), survey responses were collected in 2018 and analysed in 2019.

RESULTS

First, 29-47 % of respondents incorrectly identified the healthier product from paired options, and respondents who self-identified as having difficulty in understanding labels were more likely to err. Second, for actual products composed primarily of refined grains, 43-51 % of respondents overstated the WG content, whereas for one product composed primarily of WG, 17 % of respondents understated the WG content.

CONCLUSIONS

The frequency of consumer misunderstanding of grain product labels was high in both study components. Potential policies to address consumer confusion include requiring disclosure of WG content as a percentage of total grain content or requiring disclosure of the grams of WG v. refined grains per serving.

Development and validation of the Dental Nutrition Knowledge Competency Scale for low-income women

OBJECTIVE

To develop and validate a Dental Nutrition Knowledge Competency Scale to assess dental health-related nutrition knowledge of low-income women.

DESIGN

This is a cross-sectional study. A literature search for foods/dietary practices related to dental caries was conducted and the items were incorporated into an initial questionnaire. A panel of ten nutrition experts evaluated it for its content, readability and relevance, and a focus group of six low-income women determined its readability and comprehension. Then the questionnaire was administered to 150 low-income women. Construct validity was evaluated by item difficulty, item discrimination and factor analysis. Internal consistency reliability was tested via Cronbach's α. In a sub-sample of forty women, test-retest reliability was established. Paired-sample t tests were conducted to examine differences between test scores at the two time points, 2 weeks apart.

SETTINGS

Community centres in low-income housing in Central Texas, USA.

PARTICIPANTS

A total of 150 low-income women, aged 18-50 years; annual household income <250 % of the federal poverty level.

RESULTS

Item difficulty and discrimination analysis resulted in elimination of eight questions. Factor analysis identified twenty-four items that loaded on three factors related to knowledge. These included foods/dietary practices that affect dental caries, added sugars in foods and on food labels, and recommended frequency of oral hygiene practices. The subscales and the completed scale exhibited good internal consistency (mean 0·7 (sd 0·97)) and test-retest reliability (mean 0·8 (sd 0·013)).

CONCLUSIONS

The Dental Nutrition Knowledge Competency Scale is a validated and reliable instrument to assess nutrition knowledge related to dental health in low-income women.

Mandating Front-of-Package Food Labels in the U.S. - What are the First Amendment Obstacles?

Front-of-package (FOP) food labels are symbols, schemes, or systems designed to communicate concise and useful nutrition-related information to consumers to facilitate healthier food choices. FOP label policies have been implemented internationally that could serve as policy models for the U.S. However, the First Amendment poses a potential obstacle to U.S. government-mandated FOP requirements. We systematically reviewed existing international and major U.S.-based nutrition-related FOP labels to consider potential U.S. policy options and conducted legal research to evaluate the feasibility of mandating a FOP label in the U.S. We identified 24 international and 6 U.S.-based FOP labeling schemes. FOP labels which only disclosed nutrient-specific data would likely meet First Amendment requirements. Certain interpretive FOP labels which provide factual information with colors or designs to assist consumers interpret the information could similarly withstand First Amendment scrutiny, but questions remain regarding whether certain colors or shapes would qualify as controversial and not constitutional. Labels that provide no nutrient information and only an image or icon to characterize the entire product would not likely withstand First Amendment scrutiny.

Hungering for the past: Nostalgic food labels increase purchase intentions and actual consumption

We proposed that nostalgic labels strengthen the appeal of food items when the items are intrinsically nostalgic (e.g., related to one's childhood). Nostalgic labels do so by fostering a sense of food comfort (i.e., safety and security) among potential consumers. Experiment 1, testing a Chinese sample, confirmed that nostalgic (vs. descriptive) labels strengthen purchase intentions of food items when such items are intrinsically nostalgic. Experiment 2 showed that nostalgic (vs. descriptive) food labels strengthen purchase intentions of intrinsically nostalgic items, and do so by virtue of their capacity to elevate food comfort. This experiment tested a U.S. sample, thus broadening the cross-cultural generalizability of the findings. Experiment 3, testing a Chinese sample, replicated the Experiment 2 findings using nostalgic versus descriptive labels of a food item, and ruled out the influence of an alternative mediator, perceived food healthiness. Finally, Experiment 4, testing also a Chinese sample, revealed that restaurant dishes are more likely to be consumed when advertised with a nostalgic (than descriptive) label. The current work makes theoretical contributions to literature on food consumption and emotions, and has practical implications for harnessing nostalgia for dietary purposes.

Reading the Nutritional Information on Food Labels Among Teachers with and without Hypertension in Brazil

Background:

To examine the associations among nutritional label use, medically diagnosed hypertension, and sociodemographic factors among teachers.

Methods:

A cross-sectional study of elementary and secondary school teachers in Londrina, Paraná, Brazil, was conducted. Data regarding sociodemographic variables, hypertension diagnosis, and the reading of nutritional information on food/beverage labels were collected in 2012–2013. Associations were analyzed using Chi-square test or Fisher's exact test, and multivariate binary logistic regression models were used to adjust for possible confounders; odds ratios (ORs), 95% confidence intervals (CIs), and adjusted P values were calculated.

Results:

Of the 978 teachers interviewed, 15% were diagnosed with hypertension, and 62.5% read nutritional information in the 12 months prior to the survey (41% frequently or always). No differences were found between teachers with and without hypertension with regard to frequent reading (frequently/always) of nutritional labels. The frequent use of nutritional labels was significantly associated with female sex (OR = 1.39; 95% CI = 1.04–1.85) and the highest monthly family income level (OR = 1.82; 95% CI = 1.07–3.11). Teachers with hypertension reported checking for sodium more frequently than those without (adjusted P value = 0.040). Medical advice (adjusted P value <0.001) and choosing healthier foods (adjusted P value = 0.002) were the major reasons for reading labels provided by teachers with and without hypertension, respectively.

Conclusions:

Checking for sodium values on nutritional labels was significantly higher among teachers with hypertension, which most likely results from medical advice, and was the major reported reason for reading these labels.

Conceptual understanding and quantity inferences: a new framework for examining consumer understanding of food energy

OBJECTIVE

The study examined two components of consumer understanding of food energy information: understanding the concept of energy and its quantity. Using this new framework, we investigated whether activity-equivalent labels facilitated interpretations of food energy compared with calorie labels and whether an image format would strengthen this facilitative effect compared with text.

DESIGN

We assessed the effect of energy representation and format in a 2 (activity v. calories)×2 (image v. text) between-subjects design. Conceptual understanding of energy was measured in terms of level of understanding and personal engagement. Quantitative understanding was measured in terms of participants' estimations of a food's contribution to their recommended daily intake and perceptions of energy values as precise or single-bound interval estimates.

SETTING

The experiment was conducted online through Qualtrics.

SUBJECTS

Eight hundred and twelve participants (55 % female, age range 18-74 years) were recruited through a national survey panel in the UK.

RESULTS

Participants were twice more likely to have a stronger conceptual understanding of energy and four times more likely to personally engage with activity labels v. calorie labels. Participants did not differ across labels in their estimations of energy quantities; however, they inferred quantities to mean exactly the stated number of calories, but at least the stated activity duration. There were no added benefits in presenting an image over the text format.

CONCLUSIONS

Activity labels can facilitate conceptual understanding of energy, but may be subject to quantitative misinterpretations. Nutrition communication should consider what people infer from quantities represented on labels.

A label survey to identify ingredients potentially containing GM organisms to estimate intake exposure in Brazil

OBJECTIVE

To identify ingredients from products and by-products derived from GM crops in packaged food products and to analyse the presence of these ingredients in the foods most commonly consumed by the Brazilian population.

DESIGN

Cross-sectional study.

SETTING

A search of the scientific literature to identify the use of products and by-products derived from GM crops in foods in Brazil and a study of food labels in a supermarket belonging to one of the ten largest supermarket chains in Brazil.

SUBJECTS

To identify the ingredients present in packaged food products and their nomenclatures, the labels of all packaged food products available for sale in a supermarket were analysed. Subsequently, the presence of potential GM ingredients in the foods most commonly consumed by the Brazilian population was analysed.

RESULTS

A total of twenty-eight GM crops' by-products with applications in the food industry (from soyabeans, corn, cotton and a yeast) were identified. Such by-products are presented as food ingredients or additives on food labels with 101 distinct nomenclatures. Most of the variety (63·8 %) and the quantity (64·5 %) of the foods most commonly consumed by Brazilians may contain a least one GM ingredient.

CONCLUSIONS

The presence of at least one potential GM ingredient was observed in more than half of the variety of foods most commonly consumed by the Brazilian population. Such ingredients were identified with distinct nomenclatures and incomplete descriptions, which may make it difficult to identify potential GM foods and confuse consumers when making food choices.

Package Information Used by Older Adults to Identify Whole Grain Foods

A structured interview protocol was used to investigate the ability of older adults (n = 89, age ≥ 65 years) to accurately determine whether three common food items were whole grain, and to assess the package information used in their decision process. Cereal and crackers, which were both whole grain products, were correctly identified by 63% and 66% of participants, respectively. Bread (a refined product), was correctly identified by only 19% of participants, while 46% of participants misidentified the bread as being whole grain. The ingredient list was the information most frequently cited in deciding if a food was whole grain, but participants varied in their ability to accurately interpret it. Package information considered nonpertinent (e.g., the Nutrition Facts label) in identifying a whole grain product was used almost as often as the ingredient list. Older adults would benefit from whole grain education programs that focus on accurately interpreting package information.

Food Label Knowledge, Usage and Attitudes of Older Adults

Few recent studies have investigated food label practices in older adults. This cross-sectional study surveyed adults, 60 years and older in Delaware (n = 100, 82% female, 74% between 60 and 79 years, 49% Caucasian, 45% African Americans) to examine associations between food label knowledge, attitudes, and usage patterns. A 28-item questionnaire assessed knowledge, attitudes, usage, and demographic information. Bivariate analysis results showed food label knowledge was associated with education and monthly income. Those reporting a high school education or less incorrectly identified calorie (P < 0.05) and carbohydrate information (P < 0.03). Monthly income ≤$2000 was associated with incorrectly interpreting carbohydrate information (P < 0.03). Label usage was associated with being female (P < 0.001), having a high school education or less (P < 0.000), being 70 years or older (P < 0.05), and having a monthly income ≤$2000 (P < 0.001). Respondent's usage and perceived label comprehension was high; however less than half could correctly interpret label information. When shown samples of the US Food and Drug Administration's proposed new labels, subjects had a very favorable attitude toward the new changes. Increasing nutrition knowledge through education interventions appropriate for older adult consumers may improve comprehension of information on the food labels.

Caloric estimation of healthy and unhealthy foods in normal-weight, overweight and obese participants

Individuals make dietary choices each time they consume food or drink, and assign labels to each item, such as un/healthy, high/low in calories, high/low in nutrients. These labels are thought to be snap judgments based on prior, and often limited nutritional knowledge. The aim of this study was to examine the perception of the caloric content of 'healthy' and 'unhealthy' foods. Participants (N=141) rated 53 food images on perceived healthiness/un-healthiness alongside the caloric content. Participants were subdivided into three groups: BMI (normal-weight, overweight, obese). Findings suggest that weight status impacts on participant's caloric estimation of foods perceived as healthy, but only marginally for unhealthy foods. However, not all foods were consistently labeled as healthy or unhealthy, on these occasions weight salience appears not to have influenced estimations of caloric content. Foods that confound the dichotomous labeling of healthy or unhealthy appear to gain a 'branding' that confers either greater or fewer calories than they actually contain, on these occasions weight salience does not appear to influence the labeling; implications are discussed.

The types and aspects of front-of-pack food labelling schemes preferred by adults and children

There is strong interest in front-of-pack labels (FoPLs) as a potential mechanism for improving diets, and therefore health, at the population level. The present study examined Australian consumers' preferences for different types and attributes of FoPLs to provide additional insights into optimal methods of presenting nutrition information on the front of food packets. Much research to date has focused on two main types of FoPLs - those expressing daily intake values for specific nutrients and those utilising 'traffic light' colour coding. This study extends this work by: (i) including the new Health Star Rating system recently introduced in Australia and New Zealand; (ii) allowing a large sample of consumers to self-nominate the evaluation criteria they consider to be most important in choosing between FoPLs; (iii) oversampling consumers of lower socioeconomic status; and (iv) including children, who consume and purchase food in their own right and also influence their parents' food purchase decisions. A cross-sectional online survey of 2058 Australian consumers (1558 adults and 500 children) assessed preferences between a daily intake FoPL, a traffic light FoPL, and the Health Star Rating FoPL. Across the whole sample and among all respondent subgroups (males vs females; adults vs children; lower socioeconomic status vs medium-high socioeconomic status; normal weight vs overweight/obese), the Health Star Rating was the most preferred FoPL (44%) and the daily intake guide was the least preferred (20%). The reasons most commonly provided by respondents to explain their preference related to ease of use, interpretive content, and salience. The findings suggest that a simple to use, interpretive, star-based food label represents a population-based nutrition promotion strategy that is considered helpful by a broad range of consumers.

Naturally good: Front-of-package claims as message cues

Excess bodyweight is a significant public health problem in the United States, increasing the risk of adverse health conditions including hypertension, diabetes, heart disease, stroke, and cancer. Americans are consuming more calories than their bodies need each day and making purchasing decisions using heuristic cues, rather than caloric information. A recent trend in food and beverage labeling is the placement of a natural claim on a product's package. Unfortunately, the United States has not established clear requirements for natural claims and manufacturers are using this term liberally. Using models of information processing as a framework, the goal of this study was to predict the effects of natural claims on message processing and evaluations. It was predicted that natural claims would be perceived as heuristics for healthfulness. A 6 (product) x 2 (claim) experimental design was carried out. Support for the prediction that natural labeled products are evaluated as more healthful was found. Despite the fact that natural products contained the same number of calories as their regular counterparts, participants estimated that natural products contained 18% fewer calories. Implications of these findings for food labeling and public health are discussed.

Use of food labels by adolescents to make healthier choices on snacks: a cross-sectional study from Sri Lanka

BACKGROUND

Unhealthy snacking is commonly seen among adolescents. Therefore, use of food labels is promoted for making healthier choices on packaged snacks. This study was conducted to assess the use of food labels in making choices on packaged snack and its associated factors among adolescents.

METHODS

A cross-sectional study was conducted in 2012 among 542 Grade 12 students in Sri Lanka. Eight classes were selected as 'clusters' for the study (two classes each from two schools that were selected randomly from each list of 'Girls only' and 'Boys only' schools in Colombo district). A self-administered questionnaire assessed their socio-demography, snacking behaviour, attitudes and nutrition knowledge related to food labels. Adolescents' use of labels was assessed by three practices (label reading frequency, attention paid to label contents and correct interpretation of six hypothetical labels of snacks). Based on total scores obtained for the three practices, 'satisfactory' (score ≥75(th) percentile mark) and 'unsatisfactory' (score <75(th) percentile mark) label users were identified. Using SPSS, associations were assessed at 0.05 significance level using Chi-square-test.

RESULTS

Of the participants, 51 % were males; 61 % spent their pocket money at least once/week on packaged snacks; predominantly on biscuits (85 %) and cola-drinks (77 %) and 88 % selected snacks on their own. The majority (74.5 %) was frequent ('always' or 'most often') label readers with female predominance (p < 0.05). Over 74 % paid attention frequently to the brand name (75 %), price (85 %) and nutrition panel (81 %). Over 64 % were able to select the better food label when given a choice between two snacks, although some did it for reasons such as attractive label (63 %). The majority (84 %) had good knowledge (obtaining more than the 75(th) percentile mark) on interpreting labels. Although not statistically significant, 'unsatisfactory' label use was higher among males (73 %), purchasing power (70.4 %) and unhealthy snacking behaviour (73 %). In contrast, among the marketing strategies, identifying known brands (73.2 %) and imported products (75.8 %) as 'good' products were significantly associated with 'unsatisfactory' label use (p < 0.05).

CONCLUSIONS

Despite having good knowledge and positive attitudes, food label use is unsatisfactory among adolescents. Skills in reading labels should be addressed in the 'School canteen policy' in Sri Lanka.

Information search behaviour, understanding and use of nutrition labeling by residents of Madrid, Spain

OBJETIVES

To describe the information search behaviour, comprehension level, and use of nutritional labeling by consumers according to sociodemographic characteristics.

STUDY DESIGN

Cross-sectional study of consumers recruited in five stores of the main supermarket chains in Madrid: a random sample of 299 consumers (response rate: 80.6%).

METHODS

Interviewers collected information about the information search behaviour, comprehension, and use of nutritional labeling using a questionnaire designed for this purpose. Analyses examined the frequency of the variables of interest. Differences were tested using the Chi-square statistic.

RESULTS

In this sample, 38.8% of consumers regularly read the nutritional labeling before making a purchase (45% of women vs 30% in men; P = 0.03) and the most common reason reported was choosing healthier products (81.3%). The proportion of people who were interested in additives and fats was the higher, (55% and 50%, respectively). Lack of time (38.9%), lack of interest (27.1%), and reading difficulties (18.1%) were the most common reasons given for not reading labels. Over half (52.4%) of consumers reported completely understanding the nutritional information on labels and 20.5% reported using such information for dietary planning.

CONCLUSIONS

Reported information search behaviour, comprehension, and use of nutritional labeling were relatively high among consumers of the study, and their main goal was picking healthier products. However, not only are there still barriers to reading the information, but also the information most relevant to health is not always read or understood. Thus, interventions to increase nutritional labeling comprehension and use are required in order to facilitate the making of healthier choices by consumers.