Comprehensive Review of Consumer, Producer, and Retailer Response to Front-of-Package and Shelf Nutrition Labeling Systems

Introduction: Food manufacturers have been adding front-of-package (FOP) nutrition information to processed food products in addition to the currently mandated Nutrition Facts Panel (NFP). Some retailers have also added summary nutrition information or symbols on store shelf labels. In efforts to combat obesity, policy-makers will need to assess whether simplified nutrition information systems influence consumers to purchase healthier foods and drive manufacturers to offer healthier products. Methods: A systematic review of the literature on consumer, producer, and retailer response to FOP and shelf nutrition labeling was conducted and over 110 U.S. and international articles were synthesized. Results: Research indicates that consumers like and understand better nutrient-specific FOP nutrition labels incorporating traffic light (TL) color-coding (e.g., red, amber, and green to indicate nutrient levels) as opposed to nutrient-specific FOP labels primarily emphasizing numeric information (e.g., % of recommended daily value) or summary check-mark symbols. Text corresponding to TL colors that indicates high, medium, or low levels of nutrients also enhances consumer understanding. FOP and shelf nutrition labels appear to increase sales of foods indicated as a “healthier choice”. FOP nutrition labels appear to stimulate producers to develop healthier products. The review revealed a lack of research comparing consumer understanding using a TL system versus an overall numerical summary score (e.g., a nutrient density score). Discussion: From a public health perspective, FOP and shelf nutrition labels could potentially improve diets by enhancing consumer awareness of nutritional content and the availability of healthier food products.