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Front-of-Pack Nutrition Label and Public Health

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 December 2018) | Viewed by 83984

Special Issue Editors

Université Paris 13, Villetaneuse, France; Equipe de Recherche en Epidémiologie Nutritionnelle (EREN)
Interests: nutritional epidemiology; nutritional public health policy; prevention of chronic diseases; food behaviors; nutritional status
Equipe de Recherche en Epidémiologie Nutritionnelle (EREN) Inserm/Inra/Cnam/Université Paris 13 ; UFR SMBH, Université Paris 13, Bobigny, France
Interests: nutritional epidemiology; mechanistic epidemiology; food behaviors; nutritional markers
Equipe de Recherche en Epidémiologie Nutritionnelle (EREN) Inserm/Inra/Cnam/Université Paris 13 ; UFR SMBH, Université Paris 13, Bobigny, France
Interests: food policy; public health nutrition; nutritional epidemiology; food behaviors

Special Issue Information

Dear Colleagues,

The purpose of this Special Issue, “Front-of-Pack Nutrition Label and Public Health”, is to provide an update of the scientific data pertaining to various front-of-pack nutrition-labels implemented (or currently adopted or currently under discussion) in different countries of the world, through studies conducted on both the nutrient profiling system underlying FOP nutrition labels, and on the graphical design of the labels. This Special Issue will also discuss FOP nutrition labels as a public health tool, the potential impacts of FOP nutrition labels and/or nutrient profiling systems on food purchases, dietary intakes and health status of populations (observational epidemiological studies, modelling studies, etc.), and food composition (reformulation and innovation). Finally, the potential role of stakeholders (namely lobbies or consumer associations), and the political process leading to the selection or rejection of FOP nutrition labels within the framework of nutrition policies will also be discussed

Dr. Serge Hercberg
Dr. Pilar Galan
Dr. Chantal Julia
Guest Editors

Manuscript Submission Information

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Keywords

  • FOP nutrition label
  • Nutritional policy
  • Nutrition profiling system
  • Consumer information
  • Nutritional reformulation
  • Nutri-Score
  • Multiple Traffic Lights
  • Health Star Rating
  • Nutrition Warnings

Published Papers (8 papers)

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Research

16 pages, 4377 KiB  
Article
Differences and Similarities between Front-of-Pack Nutrition Labels in Europe: A Comparison of Functional and Visual Aspects
by Daphne L. M. van der Bend and Lauren Lissner
Nutrients 2019, 11(3), 626; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11030626 - 14 Mar 2019
Cited by 43 | Viewed by 12731
Abstract
Many different front-of-pack (FOP) nutrition labels have been introduced worldwide. To continue the debate on the most effective FOP labels for increased consumer health, full comprehension of their visual and functional features is relevant. This paper compares and provides an overview of all [...] Read more.
Many different front-of-pack (FOP) nutrition labels have been introduced worldwide. To continue the debate on the most effective FOP labels for increased consumer health, full comprehension of their visual and functional features is relevant. This paper compares and provides an overview of all FOP labels currently in practice or in preparation in Europe, by means of the visually oriented Funnel Model. The Funnel Models were completed in collaboration with the respective FOP labelling initiatives. In total, six positive FOP labels, two mixed FOP labels and one negative FOP label were compared. There are multiple similarities and differences between the FOP labels, with each FOP label being characterised by a unique set of criteria and methodological approach. This Funnel Model comparison provides the knowledge to ultimately find more common ground for all stakeholders involved in the FOP labelling debate. Importantly, implementation and evaluation activities carried out by FOP labelling organisations are crucial success factors for FOP labels in practice. We conclude that more attention should be paid to methodological differences between FOP labels and recommend that the current comparison is expanded to a global level and periodically updated, as the variety of FOP labels in the global marketplace is changing constantly. Full article
(This article belongs to the Special Issue Front-of-Pack Nutrition Label and Public Health)
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24 pages, 2178 KiB  
Article
The Effect of Randomly Providing Nutri-Score Information on Actual Purchases in Colombia
by Claudio A. Mora-García, Luisa Fernanda Tobar and Jeremy C. Young
Nutrients 2019, 11(3), 491; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11030491 - 26 Feb 2019
Cited by 20 | Viewed by 8971
Abstract
Recently, front-of-package (FOP) food labeling systems have captured the attention of researchers and policy makers. Several Latin American governments are currently considering employing different FOP labeling systems. However, there is much need for more research-based evidence in these countries. In this paper, we [...] Read more.
Recently, front-of-package (FOP) food labeling systems have captured the attention of researchers and policy makers. Several Latin American governments are currently considering employing different FOP labeling systems. However, there is much need for more research-based evidence in these countries. In this paper, we study whether food-purchasing decisions and the nutritional qualities of those purchases are influenced by randomly informing some customers and not others about an FOP label known as Nutri-Score. We also separate the information effect from the effect of being aware of the system. We combined a randomized field intervention in a university cafeteria in Bogotá, Colombia with data from an after-purchase survey and receipts. We found that randomly providing information on Nutri-Score increased total expenditure by $0.18. Additional spending on healthier items was 21% or $0.26 higher, with no change for less healthy items. Expenditure estimates were higher among customers who were aware of the system’s existence. Customers in the study were also 10% more likely to buy a healthier item than control customers were, and the concentration of protein in their purchases was greater. Information on the Nutri-Score system increased the store’s sales. This potential financial incentive may facilitate the implementation of Nutri-Score. Full article
(This article belongs to the Special Issue Front-of-Pack Nutrition Label and Public Health)
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19 pages, 1512 KiB  
Article
Setting Policy Priorities for Front-of-Pack Health Claims and Symbols in the European Union: Expert Consensus Built by Using a Delphi Method
by Yung Hung, Sophie Hieke, Klaus G Grunert and Wim Verbeke
Nutrients 2019, 11(2), 403; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11020403 - 14 Feb 2019
Cited by 22 | Viewed by 5501
Abstract
Despite the fact that front-of-pack nutrition labels such as health claims and symbols have received growing attention in consumer behavior research, comprehensive conclusions could not yet be drawn to develop concrete policy actions, owing to the complexity of the subject and a constantly [...] Read more.
Despite the fact that front-of-pack nutrition labels such as health claims and symbols have received growing attention in consumer behavior research, comprehensive conclusions could not yet be drawn to develop concrete policy actions, owing to the complexity of the subject and a constantly changing market environment. In this study, evidence-based policy recommendations and communication guidelines have been derived from the findings of the EU FP7 project CLYMBOL (“Role of health-related CLaims and sYMBOLs in consumer behavior”, Grant Agreement 311963), and have been evaluated and prioritized by European stakeholders using a three-round Delphi method. A moderate level of consensus was achieved and results suggest that policy priority should focus on ways to improve consumer motivation and interest in healthy eating. Consumers’ interest in healthy eating could be increased by adopting appropriate communication strategies such as using innovative ways to communicate the importance of healthy eating, which may aim to change the possible negative association between healthiness and tastiness. The highest-rated finding was related to consumers’ favorable attitude towards health claims with shorter and less complex messages and health symbols with a visible endorsement. Meanwhile, there was a clear consensus that health claims need to be scientifically substantiated and credible but phrased without using overly complex scientific wordings, in order to be meaningful for consumers. Furthermore, stakeholders from academia and industry believe that consumer awareness about existing health claims should be increased. The identified policy recommendations and communication guidelines stem from recent empirical evidence and provide useful insights that guide future policy development aligning consumer protection issues as well as public health and food marketing communication interests. Full article
(This article belongs to the Special Issue Front-of-Pack Nutrition Label and Public Health)
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14 pages, 473 KiB  
Article
Global Governance of Front-of-Pack Nutrition Labelling: A Qualitative Analysis
by Anne Marie Thow, Alexandra Jones, Carmen Huckel Schneider and Ronald Labonté
Nutrients 2019, 11(2), 268; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11020268 - 25 Jan 2019
Cited by 36 | Viewed by 7458
Abstract
The Codex Alimentarius has approved ongoing work for international guidance on front-of-pack (FoP) nutrition labelling, which is a core intervention for prevention of diet-related noncommunicable disease. This guidance will have implications for national policy decision-making regarding this important public health issue. However, FoP [...] Read more.
The Codex Alimentarius has approved ongoing work for international guidance on front-of-pack (FoP) nutrition labelling, which is a core intervention for prevention of diet-related noncommunicable disease. This guidance will have implications for national policy decision-making regarding this important public health issue. However, FoP nutrition labelling is also a trade and commerce policy issue. In this study, we analyze the global governance of FoP nutrition labelling and current policy processes, to inform public health policy and advocacy. We present findings from a qualitative governance and institutional analysis, based on key informant interviews with 28 global actors. The study found that Codex guidance was perceived as likely to have a high impact on FoP nutrition labelling globally. However, a small and highly interconnected “regime complex” of international institutions surrounds FoP nutrition labelling at the global level, and influence on Codex discussions is being exerted differentially by actors at the national and global level, particularly by government and industry actors. There are thus risks associated with conflicts of interests in the development of global guidance on FoP nutrition labelling. There are also opportunities for more strategic and coordinated public health engagement. Full article
(This article belongs to the Special Issue Front-of-Pack Nutrition Label and Public Health)
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10 pages, 422 KiB  
Article
The Food Supply Prior to the Implementation of the Chilean Law of Food Labeling and Advertising
by Rebecca Kanter, Marcela Reyes, Boyd Swinburn, Stefanie Vandevijvere and Camila Corvalán
Nutrients 2019, 11(1), 52; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11010052 - 28 Dec 2018
Cited by 26 | Viewed by 5891
Abstract
This study aimed to evaluate the composition of the food supply ahead of the implementation of the Chilean Law of Food Labeling and Advertising (Law 20.606) in June 2016. The INFORMAS (International Network for Food and Obesity/Non-communicable Diseases (NCDs) Research, Monitoring and Action [...] Read more.
This study aimed to evaluate the composition of the food supply ahead of the implementation of the Chilean Law of Food Labeling and Advertising (Law 20.606) in June 2016. The INFORMAS (International Network for Food and Obesity/Non-communicable Diseases (NCDs) Research, Monitoring and Action Support) framework for monitoring the composition of the food supply was used. The Law’s initial (2016) and final (2019) limits were used to evaluate if foods would receive a “High in” warning for Calories, Sodium, Sugars and/or Saturated Fats (initial/final, solids: >350/275 kcal; >800/400 mg; >22.5/10 g; >6/4 g; liquids: >100/70 kcal; >100/100 mg; >6/5 g; >3/3 g respectively). Foods were excluded if they required reconstitution, had missing information or if total labeled energy was estimated as incorrect (n = 942). In February 2015 and 2016, fieldworkers photographed a purposeful sample of packaged food and beverage products (n = 5421 and n = 5479) from 6 different supermarkets in Santiago, Chile. Seven percent of foods had no added critical nutrients (n = 720). Two-thirds of products had critical nutrients exceeding at least one initial limit indicative of a “high in” warning. Under the final phase limits, only 17% of foods would have zero warning labels. By 2019, 10 of the 17 food and beverage categories studied are predicted to have less than half of their products without a high in sodium warning label. While 8 of the 17 categories studied are predicted to have less than half their products without a high in total sugars or a high in total calories warning label, respectively; while even fewer food and beverage categories are predicted to be without a high in saturated fat warning label. Most products will have to be reformulated to avoid at least one front-of-package warning label. Full article
(This article belongs to the Special Issue Front-of-Pack Nutrition Label and Public Health)
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15 pages, 1000 KiB  
Article
Objective Understanding of Front-of-Package Nutrition Labels: An International Comparative Experimental Study across 12 Countries
by Manon Egnell, Zenobia Talati, Serge Hercberg, Simone Pettigrew and Chantal Julia
Nutrients 2018, 10(10), 1542; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10101542 - 18 Oct 2018
Cited by 164 | Viewed by 24371
Abstract
Front-of-Package labels (FoPLs) are efficient tools for increasing consumers’ awareness of foods’ nutritional quality and encouraging healthier choices. A label’s design is likely to influence its effectiveness; however, few studies have compared the ability of different FoPLs to facilitate a consumer understanding of [...] Read more.
Front-of-Package labels (FoPLs) are efficient tools for increasing consumers’ awareness of foods’ nutritional quality and encouraging healthier choices. A label’s design is likely to influence its effectiveness; however, few studies have compared the ability of different FoPLs to facilitate a consumer understanding of foods’ nutritional quality, especially across sociocultural contexts. This study aimed to assess consumers’ ability to understand five FoPLs [Health Star Rating system (HSR), Multiple Traffic Lights (MTL), Nutri-Score, Reference Intakes (RIs), and Warning symbol] in 12 different countries. In 2018, approximately 1000 participants per country were recruited and asked to rank three sets of label-free products (one set of three pizzas, one set of three cakes, and one set of three breakfast cereals) according to their nutritional quality, via an online survey. Participants were subsequently randomised to one of five FoPL conditions and were again asked to rank the same sets of products, this time with a FoPL displayed on pack. Changes in a participants’ ability to correctly rank products across the two tasks were assessed by FoPL using ordinal logistic regression. In all 12 countries and for all three food categories, the Nutri-Score performed best, followed by the MTL, HSR, Warning symbol, and RIs. Full article
(This article belongs to the Special Issue Front-of-Pack Nutrition Label and Public Health)
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19 pages, 1291 KiB  
Article
Alignment of Supermarket Own Brand Foods’ Front-of-Pack Nutrition Labelling with Measures of Nutritional Quality: An Australian Perspective
by Claire Elizabeth Pulker, Georgina S. A. Trapp, Jane Anne Scott and Christina Mary Pollard
Nutrients 2018, 10(10), 1465; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10101465 - 09 Oct 2018
Cited by 13 | Viewed by 5795
Abstract
Two voluntary front-of-pack nutrition labels (FOPNL) are present in Australia: the government-led Health Star Ratings (HSR) and food industry-led Daily Intake Guide (DIG). Australia’s two largest supermarkets are key supporters of HSR, pledging uptake on all supermarket own brand foods (SOBF). This study [...] Read more.
Two voluntary front-of-pack nutrition labels (FOPNL) are present in Australia: the government-led Health Star Ratings (HSR) and food industry-led Daily Intake Guide (DIG). Australia’s two largest supermarkets are key supporters of HSR, pledging uptake on all supermarket own brand foods (SOBF). This study aimed to examine prevalence of FOPNL on SOBF, and alignment with patterns of nutritional quality. Photographic audits of all SOBF present in three large supermarkets were conducted in Perth, Western Australia, in 2017. Foods were classified as nutritious or nutrient-poor based on the Australian Guide to Healthy Eating (AGTHE), NOVA level of food processing, and HSR score. Most (81.5%) SOBF featured FOPNL, with only 55.1% displaying HSR. HSR was present on 69.2% of Coles, 54.0% of Woolworths, and none of IGA SOBF. Half (51.3%) of SOBF were classified as nutritious using the AGTHE, but using NOVA, 56.9% were ultra-processed foods. Nutrient-poor and ultra-processed SOBF were more likely than nutritious foods to include HSR, yet many of these foods achieved HSR scores of 2.5 stars or above, implying they were a healthy choice. Supermarkets have a powerful position in the Australian food system, and they could do more to support healthy food selection through responsible FOPNL. Full article
(This article belongs to the Special Issue Front-of-Pack Nutrition Label and Public Health)
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13 pages, 1357 KiB  
Article
Uptake of Australia’s Health Star Rating System
by Alexandra Jones, Maria Shahid and Bruce Neal
Nutrients 2018, 10(8), 997; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10080997 - 30 Jul 2018
Cited by 39 | Viewed by 11818
Abstract
In June 2014, Australia and New Zealand adopted a voluntary front-of-pack nutrition labelling scheme in the form of the Health Star Rating (HSR) system. Our aim was to assess its uptake in Australia while a formal five-year review of the system is underway. [...] Read more.
In June 2014, Australia and New Zealand adopted a voluntary front-of-pack nutrition labelling scheme in the form of the Health Star Rating (HSR) system. Our aim was to assess its uptake in Australia while a formal five-year review of the system is underway. Numbers and proportions of products eligible to carry a HSR were recorded each year between 2014 and 2017 as part of an annual survey of four large Australian retail outlets. Mean HSR values were determined for products that were and were not labelled with a HSR logo, and summary data presented overall, by HSR score, by major food category, and for leading manufacturers. Results show that uptake is increasing: HSR appeared on 4348/15,767 (28%) of eligible products in 2017 and has now appeared on 7922 products since implementation. Of those products displaying a HSR logo, more than three-quarters (76.4%) displayed a HSR of ≥3.0. Products displaying a HSR logo had a higher mean HSR (3.4), compared to products not displaying a HSR logo (2.7). Uptake was highest on convenience foods (44%), cereals (36.7%), and fruit and vegetable products (35.9%). More than 100 manufacturers were using the system, but retailers Coles, Woolworths and Aldi were together responsible for 54% of uptake. For all except Coles, Woolworths and Campbell Arnott’s, the mean HSR of products displaying a logo on pack was higher than products made by that manufacturer not showing a HSR logo. We conclude that to ensure the consistent and widespread uptake required for consumers to make informed food purchases, HSR should be made mandatory at the conclusion of the five-year review. Full article
(This article belongs to the Special Issue Front-of-Pack Nutrition Label and Public Health)
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