Improving the design of nutrition labels to promote healthier food choices and reasonable portion sizes

International Journal of Obesity

Volumn 38, Issue SUPPL. 1, 2014, Pages

  Roberto, C A ^a   Khandpur, N ^a  

^a HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CONFERENCE PAPER; CONSUMER; DECISION MAKING; DIET; FOOD PACKAGING; HEALTH PROMOTION; INTERPERSONAL COMMUNICATION; NUTRITIONAL HEALTH; NUTRITIONAL VALUE; OBESITY; PORTION SIZE; PRIORITY JOURNAL; PUBLIC HEALTH SERVICE; ATTITUDE TO HEALTH; CONSUMER ATTITUDE; ECONOMICS; FOOD INDUSTRY; FOOD PREFERENCE; HEALTH BEHAVIOR; HEALTH CARE POLICY; HUMAN; PSYCHOLOGY; PUBLIC HEALTH; STANDARDS;

CHOICE BEHAVIOR; CONSUMER BEHAVIOR; FOOD INDUSTRY; FOOD LABELING; FOOD PREFERENCES; HEALTH BEHAVIOR; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HUMANS; NUTRITION POLICY; OBESITY; PORTION SIZE; PUBLIC HEALTH;

EID: 84904537808     PISSN: 03070565     EISSN: 14765497     Source Type: Journal    
DOI: 10.1038/ijo.2014.86     Document Type: Conference Paper

References (91)

1. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA 2012; 307: 491-497.
2. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA 2012; 307: 483-490.
3. French SA, Story M, Jeffery RW. Environmental influences on eating and physical activity. Annu Rev Public Health 2001; 22: 309-335.
4. Hill JO, Peters JC. Environmental contributions to the obesity epidemic. Science 1998; 280: 1371-1374.
5. Jeffery RW, Utter J. The changing environment and population obesity in the united states. Obes Res 2003; 11: 12S-22S.
6. Sallis JF, Glanz K. Physical activity and food environments: Solutions to the obesity epidemic. Milbank Q 87: 123-154.
7. Kant AK. Consumption of energy-dense, nutrient-poor foods by adult americans: nutritional and health implications. The Third National Health and Nutrition Examination Survey, 1988-1994. Am J Clin Nutr 2000; 72: 929-936.
8. National Restaurant Association. Restaurant industry pocket factbook; Available from http://www.restaurant.org/Downloads/PDFs/News-Research/ Factbook2013-LetterSize.pdf. Accessed January 2014.
9. Guthrie J, Biing-Hwan L, Frazao E. Role of food prepared away from home in the American diet, 1977-78 versus 1994-96: changes and consequences. J Nutr Educ Behav 2002; 34: 140-150.
10. Piernas C, Popkin BM. Trends in snacking among U.S. children. Health Aff (Millwood) 2010; 29: 3398-3404.
11. Popkin BM, Piernas C. Snacking increased among U.S. adults between 1977 and 2006. J Nutr 2010; 140: 325-332.
12. Young LR, Nestle M. The contribution of expanding portion sizes to the US obesity epidemic. Am J Public Health 2002; 92: 246-249.
13. Young LR, Nestle M. Reducing portion sizes to prevent obesity: A call to action. Am J Prev Med 2012; 43: 565-568.
14. Young LR, Nestle M. Expanding portion sizes in the US marketplace: Implications for nutrition counseling. J Am Diet Assoc 2003; 103: 231-234.
15. Ello-Martin JA, Ledikwe JH, Rolls BJ. The influence of food portion size and energy density on energy intake: implications for weight management. Am J Clin Nutr 2005; 82: 236S-241SS.
16. Ledikwe JH, Ello-Martin JA, Rolls BJ. Portion sizes and the obesity epidemic. J Nutr 2005; 135: 905-909.
17. Diliberti N, Bordi PL, Conklin MT, Roe LS, Rolls BJ. Increased portion size leads to increased energy intake in a restaurant meal. Obes Res 2004; 12: 562-568.
18. United States Department of Agriculture and United States Department of Health and Human Services. Dietary Guidelines for Americans 2010. Available at http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2010/PolicyDoc/ PolicyDoc.pdf. Accessed June 2013.
19. Sassi F, Cecchini M, Lauer J, Chisholm D. Improving Lifestyles, Tackling Obesity: The Health and Economic Impact of Prevention Strategies. (No. 48). OECD Publishing, 2009.
20. Food and Drug Administration. Nutrition facts label: 20 and evolving. Available at http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/ UCM334876.pdf. Accessed on June 2013.
21. Food and Drug Administration. New front-of-package labeling intiative. 2009. Available at http://www.fda.gov/food/labelingnutrition/ucm202726.htm. Accessed October 2010.
22. Wartella EA, Lichtenstein AH, Boon CS. Examination of Front-Of-Package Nutrition Rating Systems and Symbols: Phase I Report. Institute of Medicine: Washington, DC, USA, 2010, http://www.nap.edu/catalog/12957.html. Accessed 30 December 2010.
23. Wartella EA, Lichtenstein AH, Yaktine A, Nathan R. Front-Of-Package Nutrition Rating Systems and Symbols: Promoting Healthier Choices. Phase II Report. The National Academies Press: Washington, DC, USA, 2011, http://www.nap.edu/catalog.php?record-id=13221. Accessed 12 November 2011.
24. Nutrition Labeling of Standard Menu Items at Chain Restaurants Sec 4205. HR 3590. 2010.
25. Eat right; available from http://www.eatright.org/Public/content.aspx?id= 4294967941. Accessed June 2013.
26. Taylor CL, Wilkening VL. How the nutrition food label was developed, part 1: The Nutrition Facts Panel. J Am Diet Assoc 2008; 108: 437-442.
27. Balasubramanian SK, Cole C. Consumers' search and use of nutrition information: the challenge and promise of the Nutrition Labeling and Education Act. J Marketing 2002; 112-127.
28. Food and drug administration. Available from http://www.fda.gov/Food/ FoodScienceResearch/ConsumerBehaviorResearch/ucm 193895.htm. Accessed June 2013.
29. Blitstein JL, Evans WD. Use of nutrition facts panels among adults who make household food purchasing decisions. J Nutr Educ Behav 2006; 38: 360-364.
30. Byrd-Bredbenner C, Alfieri L, Kiefer L. The nutrition label knowledge and usage behaviours of women in the US. Nutr Bull 2000; 25: 315-322.
31. Ollberding NJ, Wolf RL, Contento I. Food label use and its relation to dietary intake among US adults. J Am Diet Assoc 2010; 110: 1233-1237.
32. Graham DJ, Jeffery RW. Location, location, location: eye-tracking evidence that consumers preferentially view prominently positioned nutrition information. J Am Diet Assoc 2011; 111: 1704-1711.
33. Campos S, Doxey J, Hammond D. Nutrition labels on pre-packaged foods: a systematic review. Public Health Nutr 2011; 14: 1496-1506.
34. Cowburn G, Stockley L. Consumer understanding and use of nutrition labelling: a systematic review. Public Health Nutr 2005; 8: 21-28.
35. Pettigrew S, Pescud M. The salience of food labeling among low-income families with overweight children. J Nutr Educ Behav 2013; 45: 332-339.
36. Lewis JE, Arheart JE, LeBlanc WG, Fleming LE, Lee DJ, Davila EP et al. Food label use and awareness of nutritional information and recommendations among persons with chronic disease. Am J Clin Nutr 2009; 90: 1351-1357.
37. Food and Drug Administration. Available from http://www.ecfr.gov/cgi-bin/ text-idx?c=ecfr&rgn=div8&view=text&node=21:2.0.1.1.2.1.1.8&idno= 21. Accessed July 2013.
38. US Food and Drug Administration. Guidance for Industry: a Food Labeling Guide. Available from http://www.fda.gov/downloads/Food/GuidanceRegulation/ UCM265446.pdf. Accessed June 2014.
39. Bryant R, Dundes L. Portion distortion: a study of college students. J Consum Aff 2005; 39: 399-408.
40. Roberto CA, Shivaram M, Martinez O, Boles C, Harris JL, Brownell KD. The smart choices front-of-package nutrition label. Influence on perceptions and intake of cereal. Appetite 2012; 58: 651-657.
41. Mohr GS, Lichtenstein DR, Janiszewski C. The effect of marketer-suggested serving size on consumer responses: the unintended consequences of consumer attention to calorie information. J Marketing 2012; 76: 59-75.
42. Wansink B, Chandon P. Can 'low-fat' nutrition labels lead to obesity? J Marketing Res 2006; 43: 605-617.
43. Panzer L, Kindig AM, Nielsen-Bohlman DA. Health Literacy: A Prescription to End Confusion. Institute of Medicine of the National Academies of Science: Washington, DC, USA, 2004.
44. Huizinga MM, Carlisle AJ, Cavanaugh KL, Davis DL, Gregory RP, Schlundt DG et al. Literacy, numeracy, and portion-size estimation skills. Am J Prev Med 2009; 36: 324-328.
45. Pelletier AL, Chang WW, Delzell JE, McCall JW. Patients' understanding and use of snack food package nutrition labels. J Am Board Fam Pract 2004; 17: 319-323.
46. Rothman RL, Housam R, Weiss H, Davis D, Gregory R, GebretsadikT et al. Patient understanding of food labels: the role of literacy and numeracy. Am J Prev Med 2006; 31: 391-398.
47. Lando AM, Labiner-Wolfe J. Helping consumers make more healthful food choices: consumer views on modifying food labels and providing point-of-purchase nutrition information at quick-service restaurants. J Nutr Educ Behav 2007; 39: 157-163.
48. Kelly B, Hughes C, Chapman K, Louie JCY, Dixon H, Crawford J et al. Consumer testing of the acceptability and effectiveness of front-of-pack food labelling systems for the australian grocery market. Health Promot Int 2009; 24: 120.
49. Malam S, Clegg S, Kirwan S, McGinigal S, Raats M, Shepherd R et al. Comprehension and Use of UK Nutrition Signpost Labelling Schemes, Food Standards Agency: London, UK. 2009. Available from https://www.foodwatch.nl/food watch-nl/foodwatch/content/e6380/e34762/e35853/e35859/pmpreport-ger.pdf. Accessed March 2013.
50. van Kleef E, van Trijp H, Paeps F, Fernández-Celemín L. Consumer preferences for front-of-pack calories labelling. Public Health Nutr 2008; 11: 203-213.
51. Misra R. Knowledge, attitudes, and label use among college students. J Am Diet Assoc 2007; 107: 2130-2134.
52. Antonuk B, Block LG. The effect of single serving versus entire package nutritional information on consumption norms and actual consumption of a snack food. J Nutr Educ Behav 2006; 38: 365-370.
53. Lando AM, Lo SC. Single-larger-portion-size and dual-column nutrition labeling may help consumers make more healthful food choices. J Acad Nutr Diet 2013; 113:241-250.
54. Kessler DA, Mande JR, Scarbrough FE. Developing the 'nutrition facts' food label. Harvard Health Policy Rev 2003; 4: 13-24.
55. Center for Science in the Public Interest. Food labeling chaos: the case for reform. Available from http://www.cspinet.org/new/pdf/food
56. Food and Drug Administration. Available from http://www.fda.gov/Food/ IngredientsPackagingLabeling/LabelingNutrition/ucm274593.htm. Accessed 12 July 2013.
57. Roodenburg AJ, Popkin BM, Seidell JC. Development of international criteria for a front of package food labelling system: the international choices programme. Eur J Clin Nutr 2011; 65: 1190-1200.
58. British Heart Foundation. Available from http://www.bhf.org.uk/get- involved/campaigning/food-labelling.aspx. Accessed 15 July 2013.
59. Liu PJ, Widsom J, Roberto CA, Liu LJ, Ubel PA. Using behavioral economics to design more effective food policies to address obesity. Appl Econ Perspect Pol 2013; e-pub ahead of print 2 October 2013; doi:10.1093/aepp/ppt027.
60. Bainbridge A. UK gives green light to food health ratings. ABC News 20 June 2013. Available from http://www.abc.net.au/news/2013-06-20/uk-gives-green- light-to-food-health-ratings/4768052. Accessed November 2013.
61. Vyth EL, Steenhuis IH, Brandt HE, Roodenburg AJ, Brug J, Seidell JC. Methodological quality of front-of-pack labeling studies: a review plus identification of research challenges. Nutr Rev 2012; 70: 709-720.
62. Hawley KL, Roberto CA, Bragg MA, Liu PJ, Schwartz MB, Brownell KD. The science on front-of-package food labels. Public Health Nutr 2013; 16: 430-439.
63. Food Marketing Institute. Available from http://www.fmi.org/docs/health- and-wellness/nk-style-guide-for-implementers-2012.pdf?sfvrsn = 2. Accessed April 2013.
64. Roberto CA, Bragg MA, Schwartz MB, Seamans MJ, Musicus A, Novak N et al. Facts up front versus traffic light food labels: a randomized controlled trial. Am J Prev Med 2012; 43: 134-141.
65. Roberto CA, Bragg MA, Seamans MJ, Mechulan RL, Novak N, Brownell KD. Evaluation of consumer understanding of different front-of-package nutrition labels, 2010-2011. Prev Chronic Dis 2012; 9: E149.
66. The American Beverage Association. Available from http://www.ameribev. org/files/332-FINAL%20ABA%20CLEAR%20ON%20CALORIES-%20(Calorie%20Label% 20Initiative%20and%20Style%20Guide).pdf. Accessed June 2013.
67. Vanderlee L, Goodman S, Sae Yang W, Hammond D. Consumer understanding of calorie amounts and serving size: implications for nutritional labelling. Can J Public Health 2012; 103: e327-e331.
68. Block JP, Condon SK, Kleinman K, Mullen J, Linakis S, Rifas-Shiman S et al. Consumers' estimation of calorie content at fast food restaurants: cross sectional observational study. BMJ 2013; 346: f2907.
69. Roberto CA, Haynos AF, Schwartz MB, Brownell KD, White MA. Calorie estimation accuracy and menu labeling perceptions among individuals with and without binge eating and/or purging disorders. Eat Weight Disord 2013; 18: 255-261.
70. Brownell KD. The LEARN Program for Weight Management, 10th edn. American Health Publishing Company: Dallas, TX, USA, 2004.
71. Geier A, Wansink B, Rozin P. Red potato chips: Segmentation cues can substantially decrease food intake. Health Psychol 2012; 31: 398-401.
72. Vyth EL, Steenhuis IH, Roodenburg AJ, Brug J, Seidell JC. Front-of-pack nutrition label stimulates healthier product development: a quantitative analysis. Int J Behav Nutr Phys Act 2010; 7: 65.
73. Elbel B, Kersh R, Brescoll VL, Dixon LB. Calorie labeling and food choices: a first look at the effects on low-income people in new york city. Health Aff (Millwood) 2009; 28: w1110-w1121.
74. Harnack LJ, French SA, Oakes JM, Story MT, Jeffery RW, Rydell SA. Effects of calorie labeling and value size pricing on fast food meal choices: results from an experimental trial. Int J Behav Nutr Phys Act 2008; 5: 63.
75. Downs JS, Loewenstein G, Wisdom J. Strategies for promoting healthier food choices. Am Econ Rev 2009; 99: 159-164.
76. Burton S, Creyer EH, Kees J, Huggins K. Attacking the obesity epidemic: the potential health benefits of providing nutrition information in restaurants. Am J Public Health 2006; 96: 1669-1675.
77. Chu YH, Frongillo EA, Jones SJ, Kaye GL. Improving patrons' meal selections through the use of point-of-selection nutrition labels. Am J Public Health 2009; 99: 2001-2005.
78. Roberto CA, Larsen PD, Agnew H, Baik J, Brownell KD. Evaluating the impact of menu labeling on food choices and intake. Am J Public Health 2010; 100:312-318.
79. Pulos E, Leng K. Evaluation of a voluntary menu-labeling program in full-service restaurants. Am J Public Health 2010; 100: 1035-1039.
80. Bollinger B, Leslie P, Sorensen AT. Calorie posting in chain restaurants. American Economic Journal. Econ Policy 2011; 3: 91-128.
81. Dumanovsky T, Huang CY, Nonas CA, Matte TD, Bassett MT, Silver LD. Changes in energy content of lunchtime purchases from fast food restaurants after introduction of calorie labelling: cross sectional customer surveys. BMJ 2011; 343: d4464.
82. Krieger JW, Chan NL, Saelens BE, Ta ML, Solet D, Fleming DW. Menu labeling regulations and calories purchased at chain restaurants. Am J Prev Med 2013; 44: 595-604.
83. Thorndike AN, Sonnenberg L, Riis J, Barraclough S, Levy DE. A 2-phase labeling and choice architecture intervention to improve healthy food and beverage choices. Am J Public Health 2012; 102: 527-533.
84. Levy DE, Riis J, Sonnenberg LM, Barraclough SJ, Thorndike AN. Food choices of minority and low-income employees: a cafeteria intervention. Am J Prev Med 2012; 43: 240-248.
85. Liu PJ, Roberto CA, Liu LJ, Brownell KD. A test of different menu labeling presentations. Appetite 2012; 59: 770-777.
86. Bleich SN, Herring BJ, Flagg DD, Gary-Webb TL. Reduction in purchases of sugar-sweetened beverages among low-income black adolescents after exposure to caloric information. Am J Public Health 2012; 102: 329-335.
87. Vermeer WM, Steenhuis IH, Leeuwis FH, Bos AE, de Boer M, Seidell JC. View the label before you view the movie: a field experiment into the impact of portion size and guideline daily amounts labelling on soft drinks in cinemas. BMC Public Health 2011; 11: 438.
88. Aydinouglu NIZ, Krishna A. Guiltless gluttony: the asymmetric effect of size labels on size perceptions and consumption. J Consum Res 2011; 37: 1095-1112.
89. Just DR, Wansink B. One man's tall is another man's small: How the framing of portion-size influences food choice. Health Econ 2014; 23: 776-791
90. Gortmaker SL, Swinburn BA, Levy D, Carter R, Mabry PL, Finegood DT et al. Changing the future of obesity: science, policy, and action. Lancet 2011; 378: 838-847.
91. Sunstein CR, Thaler R. Nudge: Improving Decisions About Health, Wealth, and Happiness. Yale University Press: New Haven, CT, USA, 2008.