"Warning: ultra-processed": an online experiment examining the impact of ultra-processed warning labels on consumers' product perceptions and behavioral intentions.
Food labeling
Front-of-pack labeling
Front-of-package labeling
Ultra-processed foods
Warning labels
Journal
The international journal of behavioral nutrition and physical activity
ISSN: 1479-5868
Titre abrégé: Int J Behav Nutr Phys Act
Pays: England
ID NLM: 101217089
Informations de publication
Date de publication:
09 Oct 2024
09 Oct 2024
Historique:
received:
15
07
2024
accepted:
20
09
2024
medline:
10
10
2024
pubmed:
10
10
2024
entrez:
10
10
2024
Statut:
epublish
Résumé
Nutrient content and degree of processing are complementary but distinct concepts, and a growing body of evidence shows that ultra-processed foods (UPFs) can have detrimental health effects independently from nutrient content. 10 + countries currently mandate front-of-package labels (FOPL) to inform consumers when products are high in added sugars, saturated fat, and/or sodium. Public health advocates have been calling for the addition of ultra-processed warning labels to these FOPLs, but the extent to which consumers would understand and be influenced by such labels remains unknown. We examined whether the addition of ultra-processed warning labels to existing nutrient warning labels could influence consumers' product perceptions and purchase intentions. In 2023, a sample of adults in Brazil (n = 1,004) answered an open-ended question about the meaning of the term "ultra-processed," followed by an online experiment where they saw four ultra-processed products carrying warning labels. Participants were randomly assigned to view either only nutrient warning labels or nutrient plus ultra-processed warning labels. Participants then answered questions about their intentions to purchase the products, product perceptions, and perceived label effectiveness. Most participants (69%) exhibited a moderate understanding of the term "ultra-processed" prior to the experiment. The addition of an ultra-processed warning label led to a higher share of participants who correctly identified the products as UPFs compared to nutrient warning labels alone (Cohen's d = 0.16, p = 0.02). However, the addition of the ultra-processed warning label did not significantly influence purchase intentions, product healthfulness perceptions, or perceived label effectiveness compared to nutrient warning labels alone (all p > 0.05). In exploratory analyses, demographic characteristics and prior understanding of the concept of UPF did not moderate the effect of ultra-processed warning labels. Ultra-processed warning labels may help consumers better identify UPFs, although they do not seem to influence behavioral intentions and product perceptions beyond the influence already exerted by nutrient warning labels. Future research should examine how ultra-processed warning labels would work for products that do and do not require nutrient warnings, as well as examine the benefits of labeling approaches that signal the health effects of UPFs. ClinicalTrials.gov, NCT05842460. Prospectively registered March 15th, 2023.
Sections du résumé
BACKGROUND
BACKGROUND
Nutrient content and degree of processing are complementary but distinct concepts, and a growing body of evidence shows that ultra-processed foods (UPFs) can have detrimental health effects independently from nutrient content. 10 + countries currently mandate front-of-package labels (FOPL) to inform consumers when products are high in added sugars, saturated fat, and/or sodium. Public health advocates have been calling for the addition of ultra-processed warning labels to these FOPLs, but the extent to which consumers would understand and be influenced by such labels remains unknown. We examined whether the addition of ultra-processed warning labels to existing nutrient warning labels could influence consumers' product perceptions and purchase intentions.
METHODS
METHODS
In 2023, a sample of adults in Brazil (n = 1,004) answered an open-ended question about the meaning of the term "ultra-processed," followed by an online experiment where they saw four ultra-processed products carrying warning labels. Participants were randomly assigned to view either only nutrient warning labels or nutrient plus ultra-processed warning labels. Participants then answered questions about their intentions to purchase the products, product perceptions, and perceived label effectiveness.
RESULTS
RESULTS
Most participants (69%) exhibited a moderate understanding of the term "ultra-processed" prior to the experiment. The addition of an ultra-processed warning label led to a higher share of participants who correctly identified the products as UPFs compared to nutrient warning labels alone (Cohen's d = 0.16, p = 0.02). However, the addition of the ultra-processed warning label did not significantly influence purchase intentions, product healthfulness perceptions, or perceived label effectiveness compared to nutrient warning labels alone (all p > 0.05). In exploratory analyses, demographic characteristics and prior understanding of the concept of UPF did not moderate the effect of ultra-processed warning labels.
CONCLUSIONS
CONCLUSIONS
Ultra-processed warning labels may help consumers better identify UPFs, although they do not seem to influence behavioral intentions and product perceptions beyond the influence already exerted by nutrient warning labels. Future research should examine how ultra-processed warning labels would work for products that do and do not require nutrient warnings, as well as examine the benefits of labeling approaches that signal the health effects of UPFs.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov, NCT05842460. Prospectively registered March 15th, 2023.
Identifiants
pubmed: 39385224
doi: 10.1186/s12966-024-01664-w
pii: 10.1186/s12966-024-01664-w
doi:
Banques de données
ClinicalTrials.gov
['NCT05842460']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
115Subventions
Organisme : Bloomberg Family Foundation
ID : 2019-71181
Organisme : NIH HHS
ID : #HD050924
Pays : United States
Organisme : NIH HHS
ID : #HD007168
Pays : United States
Informations de copyright
© 2024. The Author(s).
Références
Monteiro CA, Cannon G, Levy RB, Moubarac JC, Louzada ML, Rauber F, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr. 2019;22(5):936–41.
pubmed: 30744710
pmcid: 10260459
doi: 10.1017/S1368980018003762
Chen X, Zhang Z, Yang H, Qiu P, Wang H, Wang F, et al. Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies. Nutr J. 2020;19(1):86.
pubmed: 32819372
pmcid: 7441617
doi: 10.1186/s12937-020-00604-1
Lane MM, Davis JA, Beattie S, Gómez-Donoso C, Loughman A, O’Neil A et al. Ultraprocessed food and chronic noncommunicable diseases: A systematic review and meta‐analysis of 43 observational studies. Obes Rev [Internet]. 2021 Mar [cited 2022 Nov 21];22(3). https://onlinelibrary.wiley.com/doi/ https://doi.org/10.1111/obr.13146
Pagliai G, Dinu M, Madarena MP, Bonaccio M, Iacoviello L, Sofi F. Consumption of ultra-processed foods and health status: a systematic review and meta-analysis. Br J Nutr. 2021;125(3):308–18.
pubmed: 32792031
doi: 10.1017/S0007114520002688
Askari M, Heshmati J, Shahinfar H, Tripathi N, Daneshzad E. Ultra-processed food and the risk of overweight and obesity: a systematic review and meta-analysis of observational studies. Int J Obes. 2020;44(10):2080–91.
doi: 10.1038/s41366-020-00650-z
Elizabeth L, Machado P, Zinöcker M, Baker P, Lawrence M. Ultra-processed Foods and Health outcomes: a narrative review. Nutrients. 2020;12(7):1955.
pubmed: 32630022
pmcid: 7399967
doi: 10.3390/nu12071955
Jardim MZ, Costa BV, de Pessoa L, Duarte MC. Ultra-processed foods increase noncommunicable chronic disease risk. Nutr Res. 2021;95:19–34.
pubmed: 34798466
doi: 10.1016/j.nutres.2021.08.006
Moradi S, Entezari MH, Mohammadi H, Jayedi A, Lazaridi AV, Kermani M ali. H, Ultra-processed food consumption and adult obesity risk: a systematic review and dose-response meta-analysis. Crit Rev Food Sci Nutr. 2021;1–12.
Silva Meneguelli T, Viana Hinkelmann J, Hermsdorff HHM, Zulet MÁ, Martínez JA, Bressan J. Food consumption by degree of processing and cardiometabolic risk: a systematic review. Int J Food Sci Nutr. 2020;71(6):678–92.
pubmed: 32053758
doi: 10.1080/09637486.2020.1725961
Moradi S, Kermani M, ali H, Bagheri R, Mohammadi H, Jayedi A, Lane MM et al. Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis. Nutrients [Internet]. 2021 [cited 2022 Nov 21];13(12). https://www.proquest.com/docview/2612821429/abstract/952338EDF2E44E53PQ/1
Lane MM, Gamage E, Du S, Ashtree DN, McGuinness AJ, Gauci S, et al. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ. 2024;384:e077310.
pubmed: 38418082
pmcid: 10899807
doi: 10.1136/bmj-2023-077310
Martini D, Godos J, Bonaccio M, Vitaglione P, Grosso G. Ultra-processed Foods and Nutritional Dietary Profile: a Meta-analysis of nationally Representative Samples. Nutrients. 2021;13(10):3390.
pubmed: 34684391
pmcid: 8538030
doi: 10.3390/nu13103390
Rolls BJ, Cunningham PM, Diktas HE. Properties of Ultraprocessed Foods that can drive excess intake. Nutr Today. 2020;55(3):109–15.
doi: 10.1097/NT.0000000000000410
Gupta S, Hawk T, Aggarwal A, Drewnowski A. Characterizing Ultra-Processed Foods by Energy Density, Nutrient Density, and Cost. Front Nutr [Internet]. 2019 [cited 2022 Nov 21];6. https://www.frontiersin.org/articles/ https://doi.org/10.3389/fnut.2019.00070
Micek A, Godos J, Grosso G. Nutrient and energy contribution of ultra-processed foods in the diet of nations: a meta-analysis. Eur J Public Health. 2021;31(Supplement3):ckab164418.
doi: 10.1093/eurpub/ckab164.418
Fardet A, Rock E. Ultra-processed foods: a new holistic paradigm? Trends Food Sci Technol. 2019;93:174–84.
doi: 10.1016/j.tifs.2019.09.016
Monteiro CA, Martínez-Steele E, Cannon G. Reasons to avoid ultra-processed foods. BMJ. 2024;384:q439.
pubmed: 38418096
doi: 10.1136/bmj.q439
Dicken SJ, Batterham RL. The role of Diet Quality in Mediating the Association between Ultra-processed Food Intake, obesity and health-related outcomes: a review of prospective cohort studies. Nutrients. 2022;14(1):23.
doi: 10.3390/nu14010023
Konieczna J, Fiol M, Colom A, Martínez-González MÁ, Salas-Salvadó J, Corella D, et al. Does Consumption of Ultra-processed Foods Matter for Liver Health? Prospective analysis among older adults with metabolic syndrome. Nutrients. 2022;14(19):4142.
pubmed: 36235794
pmcid: 9570694
doi: 10.3390/nu14194142
Wang L, Du M, Wang K, Khandpur N, Rossato SL, Drouin-Chartier JP, et al. Association of ultra-processed food consumption with colorectal cancer risk among men and women: results from three prospective US cohort studies. BMJ. 2022;378:e068921.
pubmed: 38752573
pmcid: 9430376
doi: 10.1136/bmj-2021-068921
Bonaccio M, Castelnuovo AD, Ruggiero E, Costanzo S, Grosso G, Curtis AD, et al. Joint association of food nutritional profile by nutri-score front-of-pack label and ultra-processed food intake with mortality: Moli-Sani prospective cohort study. BMJ. 2022;378:e070688.
pubmed: 36450651
pmcid: 9430377
doi: 10.1136/bmj-2022-070688
Chen X, Chu J, Hu W, Sun N, He Q, Liu S, et al. Associations of ultra-processed food consumption with cardiovascular disease and all-cause mortality: UK Biobank. Eur J Public Health. 2022;32(5):779–85.
pubmed: 36006020
pmcid: 9527958
doi: 10.1093/eurpub/ckac104
Du S, Kim H, Crews DC, White K, Rebholz CM. Association between Ultraprocessed Food Consumption and Risk of Incident CKD: a prospective cohort study. Am J Kidney Dis. 2022;80(5):589–e5981.
pubmed: 35679994
pmcid: 9613500
doi: 10.1053/j.ajkd.2022.03.016
Sellem L, Srour B, Javaux G, Chazelas E, Chassaing B, Viennois E, et al. Food additive emulsifiers and cancer risk: results from the French prospective NutriNet-Santé cohort. PLOS Med. 2024;21(2):e1004338.
pubmed: 38349899
pmcid: 10863884
doi: 10.1371/journal.pmed.1004338
Monteiro CA, Cannon G, Levy R, Moubarac JC, Jaime P, Martins AP, et al. NOVA. The star shines bright. World Nutr. 2016;7(1–3):28–38.
Dietary Guidelines for the Brazilian Population [Internet], Brasília DF. Ministry of Health of Brazil; 2015 Jan. https://bvsms.saude.gov.br/bvs/publicacoes/dietary_guidelines_brazilian_population.pdf
Louzada ML, da Cruz C, da Silva GL, Grassi KAAN, Andrade AGF, Rauber GC. F, Consumo de alimentos ultraprocessados no Brasil: distribuição e evolução temporal 2008–2018. Rev Saúde Pública [Internet]. 2023 Feb 15 [cited 2024 Jan 16];57. https://rsp.fsp.usp.br/wp-content/plugins/xml-to-html/include/lens/index.php/?xml=1518-8787-rsp-57-12.xml#content/figure_reference_7
Nilson EAF, Ferrari G, Louzada MLC, Levy RB, Monteiro CA, Rezende LFM. Premature Deaths Attributable to the Consumption of Ultraprocessed Foods in Brazil. Am J Prev Med [Internet]. 2022 Nov 7 [cited 2022 Nov 16];0(0). https://www.ajpmonline.org/article/S0749-3797(22)00429-9/fulltext
Roberto CA, Ng SW, Ganderats-Fuentes M, Hammond D, Barquera S, Jauregui A, et al. The influence of Front-of-Package Nutrition Labeling on consumer behavior and product reformulation. Annu Rev Nutr. 2021;41(1):529–50.
pubmed: 34339293
doi: 10.1146/annurev-nutr-111120-094932
WHO. Guiding principles and framework manual for front-of-pack labelling for promoting healthy diet [Internet]. 2019. https://cdn.who.int/media/docs/default-source/healthy-diet/guidingprinciples-labelling-promoting-healthydiet.pdf?sfvrsn=65e3a8c1_7&download=true
Taillie LS, Hall MG, Popkin BM, Ng SW, Murukutla N. Experimental studies of front-of-Package nutrient warning labels on Sugar-Sweetened beverages and Ultra-processed foods: a scoping review. Nutrients. 2020;12(2):569.
pubmed: 32098363
pmcid: 7071470
doi: 10.3390/nu12020569
Global Food Research Program UNC. Front-of-package labeling map [Internet]. 2022. https://www.globalfoodresearchprogram.org/wp-content/uploads/2022/02/FOP_Regs_maps_2022_02.pdf
Cotter T, Kotov A, Wang S, Murukutla N. Warning: ultra-processed’ — a call for warnings on foods that aren’t really foods. BMJ Glob Health. 2021;6(12):e007240.
pubmed: 34933866
pmcid: 8666852
doi: 10.1136/bmjgh-2021-007240
D’Angelo Campos A, Ng SW, McNeel K, Hall MG. How promising are Ultraprocessed Front-of-Package labels? A formative study with US adults. Nutrients. 2024;16(7):1072.
pubmed: 38613105
pmcid: 11013171
doi: 10.3390/nu16071072
Srour B, Hercberg S, Galan P, Monteiro CA, Szabo de Edelenyi F, Bourhis L, et al. Effect of a new graphically modified nutri-score on the objective understanding of foods’ nutrient profile and ultraprocessing: a randomised controlled trial. BMJ Nutr Prev Health. 2023;6(1):108–18.
pubmed: 37484539
pmcid: 10359533
doi: 10.1136/bmjnph-2022-000599
Grummon AH, Tucker AC, Noe V, Rummo PE, Prestemon CE, Hall MG, et al. Consumer behaviour and experiences in a naturalistic online grocery store: implications for nutrition research. J Nutr Sci. 2023;12:e36.
pubmed: 37008411
pmcid: 10052388
doi: 10.1017/jns.2023.21
Rummo PE, Higgins I, Chauvenet C, Vesely A, Jaacks LM, Taillie L. A standardized guide to developing an online grocery store for Testing Nutrition-related policies and interventions in an online setting. Int J Environ Res Public Health. 2021;18(9):4527.
pubmed: 33923246
pmcid: 8123213
doi: 10.3390/ijerph18094527
Grummon AH, Hall MG, Taillie LS, Brewer NT. How should sugar-sweetened beverage health warnings be designed? A randomized experiment. Prev Med. 2019;121:158–66.
pubmed: 30772370
pmcid: 6520104
doi: 10.1016/j.ypmed.2019.02.010
Louzada ML, da Baraldi C, Steele LG, Martins EM, Canella APB, Moubarac DS. Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults. Prev Med. 2015;81:9–15.
pubmed: 26231112
doi: 10.1016/j.ypmed.2015.07.018
Lima M, de Alcantara M, Rosenthal A, Deliza R. Effectiveness of traffic light system on Brazilian consumers perception of food healthfulness. Food Sci Hum Wellness. 2019;8(4):368–74.
doi: 10.1016/j.fshw.2019.10.001
Lima M, Ares G, Deliza R. How do front of pack nutrition labels affect healthfulness perception of foods targeted at children? Insights from Brazilian children and parents. Food Qual Prefer. 2018;64:111–9.
doi: 10.1016/j.foodqual.2017.10.003
Machín L, Aschemann-Witzel J, Curutchet MR, Giménez A, Ares G. Traffic Light System can increase Healthfulness Perception: implications for policy making. J Nutr Educ Behav. 2018;50(7):668–74.
pubmed: 29627330
doi: 10.1016/j.jneb.2018.03.005
van Kesteren R, Evans A. Cooking without thinking: how understanding cooking as a practice can shed new light on inequalities in healthy eating. Appetite. 2020;147:104503.
pubmed: 31707071
doi: 10.1016/j.appet.2019.104503
D’Angelo Campos A, Taillie LS, Vatavuk-Serrati G, Grummon AH, Higgins ICA, Hall MG. Effects of pictorial warnings on parents’ purchases and perceptions of sugar-sweetened beverage categories. Pediatr Obes. 2023;18(7):e13030.
pubmed: 36965067
pmcid: 10687846
doi: 10.1111/ijpo.13030
Noar SM, Gottfredson N, Vereen RN, Kurtzman R, Sheldon JM, Adams E et al. Development of the UNC Perceived Message Effectiveness Scale for Youth. Tob Control [Internet]. 2021 Dec 20 [cited 2023 Mar 14]; https://tobaccocontrol.bmj.com/content/early/2021/12/19/tobaccocontrol-2021-056929
Hall MG, Lazard AJ, Grummon AH, Higgins ICA, Bercholz M, Richter APC, et al. Designing warnings for sugary drinks: a randomized experiment with latino parents and non-latino parents. Prev Med. 2021;148:106562.
pubmed: 33878350
pmcid: 8958622
doi: 10.1016/j.ypmed.2021.106562
Brewer NT, Parada H, Hall MG, Boynton MH, Noar SM, Ribisl KM. Understanding why pictorial cigarette pack warnings increase quit attempts. Ann Behav Med. 2019;53(3):232–43.
pubmed: 29850764
doi: 10.1093/abm/kay032
Grummon AH, Brewer NT. Health warnings and Beverage Purchase Behavior: mediators of impact. Ann Behav Med. 2020;54(9):691–702.
pubmed: 32182336
pmcid: 7459182
doi: 10.1093/abm/kaaa011
Xu W, Zammit K. Applying thematic analysis to education: a Hybrid Approach to Interpreting Data in Practitioner Research. Int J Qual Methods. 2020;19:1609406920918810.
doi: 10.1177/1609406920918810
Swain J. Sage Research Methods Cases Part 2 - A Hybrid Approach to Thematic Analysis in Qualitative Research: Using a Practical Example [Internet]. 2018 [cited 2024 Aug 16]. https://methods.sagepub.com/case/hybrid-approach-thematic-analysis-qualitative-research-a-practical-example
Demonstrating Rigor Using Thematic Analysis. A Hybrid Approach of Inductive and Deductive Coding and Theme Development - Jennifer Fereday, Eimear Muir-Cochrane, 2006 [Internet]. [cited 2024 Aug 16]. https://journals.sagepub.com/doi/full/10.1177/160940690600500107
Síntese de Indicadores Sociais: Uma análise das condições de vida da população brasileira [Internet]. Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística. 2023. https://biblioteca.ibge.gov.br/visualizacao/livros/liv102052.pdf
Panorama do Censo. 2022 [Internet]. [cited 2024 Apr 10]. Panorama do Censo 2022. https://censo2022.ibge.gov.br/panorama/
Ares G, Vidal L, Allegue G, Giménez A, Bandeira E, Moratorio X, et al. Consumers’ conceptualization of ultra-processed foods. Appetite. 2016;105:611–7.
pubmed: 27349706
doi: 10.1016/j.appet.2016.06.028
Aguirre A, Borneo MT, El Khori S, Borneo R. Exploring the understanding of the term ultra-processed foods by young consumers. Food Res Int. 2019;115:535–40.
pubmed: 30599975
doi: 10.1016/j.foodres.2018.09.059
Menegassi B, Scagliusi FB, Nardocci M, Moubarac JC. Knowledge of the NOVA food classification in a sample of Brazilian adults. Rev Chil Nutr. 2020;47(6):950–9.
doi: 10.4067/S0717-75182020000600950
Sen SB. Childhood Diabetes Reduction Act of 2024 [Internet]. Sect. 118th Congress, S.4195 Apr 18, 2024. https://www.congress.gov/bill/118th-congress/senate-bill/4195/text
Arellano-Gómez LP, Jáuregui A, Nieto C, Contreras-Manzano A, Quevedo KL, White CM, et al. Effects of front-of-package caffeine and sweetener disclaimers in Mexico: cross-sectional results from the 2020 International Food Policy Study. Public Health Nutr. 2023;26(12):3278–90.
pubmed: 37781769
pmcid: 10755452
doi: 10.1017/S1368980023002100
Valenzuela A, Zambrano L, Velásquez R, Groff C, Apablaza T, Riffo C, et al. Discrepancy between food classification systems: evaluation of Nutri-Score, NOVA classification and Chilean front-of-Package Food warning labels. Int J Environ Res Public Health. 2022;19(22):14631.
pubmed: 36429354
pmcid: 9690311
doi: 10.3390/ijerph192214631
Popkin BM, Miles DR, Tallie L, Dunford EK. A Policy Approach to Identifying Food and Beverage Products that are Ultra Processed and High in Added Salt, Sugar and Saturated Fat [Internet]., Rochester NY. 2023 [cited 2024 Mar 8]. https://papers.ssrn.com/abstract=4540298
Zancheta Ricardo C, Corvalán C, Smith Taillie L, Quitral V, Reyes M. Changes in the Use of Non-nutritive Sweeteners in the Chilean Food and Beverage Supply After the Implementation of the Food Labeling and Advertising Law. Front Nutr [Internet]. 2021 [cited 2024 Feb 22];8. https://www.frontiersin.org/articles/ https://doi.org/10.3389/fnut.2021.773450
Rebolledo N, Bercholz M, Corvalán C, Ng SW, Taillie LS. Did the sweetness of beverages change with the Chilean Food Labeling and Marketing Law? A before and after study. Front Nutr [Internet]. 2022 [cited 2024 Feb 22];9. https://www.frontiersin.org/articles/ https://doi.org/10.3389/fnut.2022.1043665
Saavedra-Garcia L, Meza-Hernández M, Diez-Canseco F, Taillie LS. Reformulation of top-selling processed and Ultra-processed foods and beverages in the Peruvian Food Supply after Front-of-Package warning label policy. Int J Environ Res Public Health. 2023;20(1):424.
doi: 10.3390/ijerph20010424
Coppock A, Leeper TJ, Mullinix KJ. Generalizability of heterogeneous treatment effect estimates across samples. Proc Natl Acad Sci. 2018;115(49):12441–6.
pubmed: 30446611
pmcid: 6298071
doi: 10.1073/pnas.1808083115
Jeong M, Zhang D, Morgan JC, Ross JC, Osman A, Boynton MH, et al. Similarities and Differences in Tobacco Control Research Findings from Convenience and Probability samples. Ann Behav Med. 2019;53(5):476–85.
pubmed: 30052702
doi: 10.1093/abm/kay059
Grummon AH, Hall MG. J Adams editor. 2020 Sugary drink warnings: a meta-analysis of experimental studies. PLOS Med 17 5 e1003120.
pubmed: 32433660
pmcid: 7239392
doi: 10.1371/journal.pmed.1003120
Goodman S, Vanderlee L, Acton R, Mahamad S, Hammond D. The impact of Front-of-Package label design on consumer understanding of nutrient amounts. Nutrients. 2018;10(11):1624.
pubmed: 30400146
pmcid: 6266389
doi: 10.3390/nu10111624
Jáuregui A, Vargas-Meza J, Nieto C, Contreras-Manzano A, Alejandro NZ, Tolentino-Mayo L, et al. Impact of front-of-pack nutrition labels on consumer purchasing intentions: a randomized experiment in low- and middle-income Mexican adults. BMC Public Health. 2020;20(1):463.
pubmed: 32252716
pmcid: 7137298
doi: 10.1186/s12889-020-08549-0
Bandeira LM, Pedroso J, Toral N, Gubert MB. Performance and perception on front-of-package nutritional labeling models in Brazil. Rev Saúde Pública. 2021;55:19.
pubmed: 33978115
pmcid: 8064653
doi: 10.11606/s1518-8787.2021055002395
Mora-Plazas M, Higgins ICA, Gomez LF, Hall M, Parra MF, Bercholz M, et al. Impact of nutrient warning labels on choice of ultra-processed food and drinks high in sugar, sodium, and saturated fat in Colombia: a randomized controlled trial. PLoS ONE. 2022;17(2):e0263324.
pubmed: 35143553
pmcid: 8830675
doi: 10.1371/journal.pone.0263324
Castronuovo L, Tiscornia MV, Guarnieri L, Martins E, Gomes FS, Allemandi L. Efficacy of different front-of-package labeling systems in changing purchase intention and product healthfulness perception for food products in Argentina. Rev Panam Salud Pública. 2022;46:e137.
pubmed: 36177304
pmcid: 9512682
doi: 10.26633/RPSP.2022.137
Jáuregui A, White CM, Vanderlee L, Hall MG, Contreras-Manzano A, Nieto C, et al. Impact of front-of-pack labels on the perceived healthfulness of a sweetened fruit drink: a randomised experiment in five countries. Public Health Nutr. 2022;25(4):1094–104.
pubmed: 34726144
doi: 10.1017/S1368980021004535