Fact-based front-of-pack labeling systems and their impact on consumer comprehension and interpretation of nutrition information

INTRODUCTION First Lady Michele Obama's Let's Move campaign has called for front-of-pack (FOP) nutrition labeling at the same time that an Institute of Medicine project is underway to define desirable qualities of such systems. To help Americans improve diet quality, we must understand how consumers interact with various forms of FOP labeling. METHODS A nationally representative sample of primary grocery shoppers (n=7,363) were uniformly split to test comprehension and interpretation of the following fact-based FOP labeling approaches: 1) no FOP nutrition information; 2) calories only; 3) calories plus “negative” nutrients; and 4) calories plus “negative” plus up to 3 “positive” nutrients. All groups had access to the Nutrition Facts Panel. RESULTS Consumers were more frequently able to accurately find and state nutritional content when the relevant information appeared FOP. “Positive” nutrients FOP improved consumers' accuracy with respect to “positive” nutrients, as well as calories and “negative” nutrients. Across all labeling systems, a majority of consumers were able to select the product considered to be the best nutritional choice. Across all labeling systems, comprehension was lowest among those with the least formal education. More FOP nutrition information led to improved comprehension for all education levels, with the greatest increase among those with the least education. DISCUSSION Fact-based FOP nutrition labeling may help to close the comprehension gap between those who have lower versus higher levels of formal education. Nutrition education must be implemented along with any FOP nutrition labeling system to enable consumers to use nutrition labeling to build healthful diets.