Deakin University

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Impact of front-of-pack labels on the perceived healthfulness of a sweetened fruit drink: A randomised experiment in five countries

journal contribution
posted on 2022-04-01, 00:00 authored by A Jáuregui, C M White, L Vanderlee, M G Hall, A Contreras-Manzano, C Nieto, Gary SacksGary Sacks, J F Thrasher, D Hammond, S Barquera
AbstractObjective:Front-of-pack (FOP) nutrition labelling is a globally recommended strategy to encourage healthier food choices. We evaluated the effect of FOP labels on the perceived healthfulness of a sweetened fruit drink in an international sample of adult consumers.Design:Six-arm randomised controlled experiment to examine the impact of FOP labels (no label control, Guideline Daily Amounts (GDA), Multiple Traffic Lights, the Health Star Ratings (HSR), Health Warning Labels, and ‘High-in’ Warning Labels (HIWL)) on the perceived healthfulness of the drink. Linear regression models by country examined healthfulness perceptions on FOP nutrition labels, testing for interactions by demographic characteristics.Setting:Online survey in 2018 among participants from Australia, Canada, Mexico, United Kingdom (UK) and United States.Participants:Adults (≥18 years, n 22 140).Results:Compared with control, HIWL had the greatest impact in lowering perceived healthfulness (β from −0·62 to −1·71) across all countries. The HIWL and the HSR had a similar effect in Australia. Other labels were effective in decreasing the perceived healthfulness of the drink within some countries only, but to a lower extent. The GDA did not reduce perceived healthfulness in most countries. In the UK, the effect of HIWL differed by age group, with greater impact among older participants (> 40 years). There were no other variations across key demographic characteristics.Conclusions:HIWL, which communicates clear, non-quantitative messages about high levels of nutrients of concern, demonstrated the greatest efficacy to decrease the perceived healthfulness of a sweetened fruit drink across countries. This effect was similar across demographic characteristics.



Public Health Nutrition





Article number

PII S1368980021004535


1094 - 1104


Cambridge University Press


Cambridge, England







Publication classification

C1 Refereed article in a scholarly journal