There is no arguing that addressing the complex public health problems of poor diet and obesity will require substantial efforts from many different players, including governments and industry. Although a number of factors contribute to obesity, at the end of the day, it comes down to the food we eat.
Over the last few decades, obesity has skyrocketed and this has been mirrored by increasing trends in the consumption of nutritionally poor and calorie-dense packaged foods. Nutrition labelling of packaged foods is one approach to educating consumers about the nutritional quality of the food they are putting in their bodies and the hope is that such labelling efforts will encourage healthier food choices when shopping.
Recently, there has been increased interest in taking key nutrition information from detailed labels that appear on the back or side of packaging and displaying it on the front of food packaging.
The idea behind a front-of-package food label is a good one. The labels are meant to quickly provide the consumer with important and easy-to-understand nutrition information at the point-of-purchase.
Consumer ConfusionIn the US, however, there has been an explosion of many types of labelling systems, leading to consumer confusion. Front-of-package labelling systems have included industry-developed symbols such as General Mills’ Goodness Corner, PepsiCo’s Smart Spot, Kraft’s Sensible Solution and Kellogg’s Nutrition at a Glance.
Non-profit organisations have also created labelling systems such as the American Heart Association’s Heart Check Mark. In addition, supermarkets have jumped on the labelling bandwagon either by introducing their own shelf-tag labelling systems, such as Harris Teeter’s Wellness Keys or Whole Foods’s ANDI score, or by licensing an existing shelf-tag system such as NuVal or Guiding Stars. These shelf-tag symbols are designed to convey health information about products through labels affixed to shelves rather than directly on packaging.
The deluge of disparate labelling systems has made an already cluttered and complicated food packaging environment more difficult to navigate. A consumer walking down a supermarket aisle now must make sense of labels appearing on packages and on shelves (with potentially conflicting information) in addition to processing other prominent product claims such as ‘All Natural’, ‘Low Fat’ or ‘Trans Fat Free’. Couple this with special offers, sponsorships, celebrities, giveaways, and other branding efforts featured on food packaging and the result is information overload.
In the US, front-of-package food labelling came to the food policy forefront when a program called Smart Choices was launched in 2009. The program was the result of collaborative efforts among members of government, the food industry and public health organisations, as well as scientists and nutrition educators.
The idea behind it made a lot of sense: introduce a uniform labelling system across food products that would guide consumers to ‘better-for-you’ products. However, when the labelling system was released, its seal of approval was emblazoned on products like Hellman’s mayonnaise, Froot Loops cereal and Fudgsicles.
The program immediately drew negative press regarding its potentially misleading nature. After threat of investigation by a state Attorney General and an announcement that the United States Food and Drug Administration (the regulatory agency that oversees packaged food labelling) was going to undertake efforts to recommend a science-based front-of-package labelling system, the program was halted.
At that point, the food industry indicated they would hold off on implementing a front-of-pack labelling system until after the FDA provided guidance. However, several months after suspension of Smart Choices, the Food Marketing Institute and Grocery Manufacturer’s Association, two of the industry’s largest trade groups, announced the launch of Facts Up Front, a front-of-package labelling system that has since been rolled out in the US.
Complex systemGiven that the goal of front-of-package labels should be to provide consumers with quick and easy to understand nutrition information, the system raises several concerns. First, the symbol is packed with information. At a minimum, the label includes icons that provide information about calories, saturated fat, sodium, and sugars per serving. This information is displayed in grams/milligrams accompanied by percent daily values.
Food manufacturers can also choose to highlight up to two “nutrients to encourage”, which include potassium, fibre, vitamins A, C and/or D, calcium, iron, and/or protein.
Research I have done with colleagues at Yale University’s Rudd Center for Food Policy and Obesity has shown that consumers find the Facts Up Front approach to be confusing, information-heavy, and time-consuming to understand.
Another concern is that the symbol lacks attention-grabbing features when competing against other eye-catching aspects of the packaging. A third concern is that the labelling scheme allows companies to cherry-pick specific nutrients such as vitamins that can be highlighted on less healthy products to make them seem healthier. This might motivate the industry to fortify less healthy foods with certain nutrients to boost their appeal.
These concerns are supported by work we have done demonstrating that when people view the label on a food product, they are more likely to underestimate the amounts of nutrients to limit, such as saturated fat and sugars, and overestimate amounts of nutrients to encourage, such as fibre and protein.
Evaluations of the Choices symbol have shown that it too can assist individuals in making healthier food choices.
Global Labelling SystemsIn comparison, simpler and more intuitive labelling systems are in use in other countries. In the UK, the Food Standards Agency developed and recommended a traffic light approach that has been used by some food manufacturers. This symbol uses simple, colourful (green, amber, red) traffic lights to alert consumers to low, medium, and high levels of nutrients to limit, including sodium, saturated fat and sugars.
There is a growing body of research indicating that a traffic light approach to food labelling is easily understood by consumers and can help them make healthier food choices. Because the traffic light approach also highlights the negative nutrients in products, it is also less likely to mislead a consumer into thinking a food is a good for you choice simply because there is a front-of-package label on it.
Other countries, such as the Netherlands, have adopted the international Choices Programme check mark system used by food companies around the world. The symbol identifies foods and beverages meeting nutrition criteria developed by an independent scientific committee, rather than members of the food industry. Evaluations of the Choices symbol have shown that it too can assist individuals in making healthier food choices.
Optimum SymbolSince there are so many front-of-package labelling systems available, it is important to determine what an optimum symbol should look like. The most useful labelling system would be a single, uniform label appearing across food and beverage products, rather than many different non-standardised labelling systems that make it difficult for consumers to evaluate and compare the nutritional profiles of foods.
Consumers would benefit most from an interpretive symbol that provides an evaluation of a food based on accurate and rigorous nutrition criteria. However, as the failed Smart Choices program demonstrated, the success of an interpretive food labelling system hinges upon criteria that are developed by independent committees of nutrition experts that have the public’s health as their only interest.
A number of principles should be kept in mind when designing a front-of-pack symbol to communicate nutrition messages. The first is simplicity. Consumers want simple labels and have trouble understanding labelling systems that include too much information.
Front-of-pack labels should avoid inclusion of percentages and units like grams and milligrams that mean little to most consumers. Front-of-pack labels should also be intuitive, which can be accomplished by using traffic light symbols that can be further simplified by including ‘high’, ‘medium’, and ‘low’ text on the lights to help consumers quickly and accurately process the message.
Other simple and intuitive approaches that have been proposed are front-of-pack symbols that award products up to three possible stars, checks or other indicators, based on the nutritional profile of the food. Many consumers, particularly those interested in losing weight, also care about calorie information and report using it.
The inclusion of calorie per serving information on a front-of-pack label can be very useful, but presenting calories per serving for products typically consumed in one sitting, like a muffin or 20 ounce soda, violates the simplicity principle. In this case, consumers should be provided with calorie information for the entire product.
Rethinking LabellingWhen we think about an optimum front-of-package label, we tend to ask, what kind of label will motivate consumers to make healthier food choices? However, an equally important question for public health is what kind of front-of-package label will motivate the food industry to offer healthier products?
After the implementation of New Zealand’s Heart Foundation Tick symbol, 33 tonnes of salt were removed from the food supply over the course of a year. The required listing of trans fat on packaged foods in the US was also followed by a reduction in the amount of trans fat in products. Similarly, the Netherlands has witnessed a reformulation of the nutritional profiles of foods following the introduction of the Choices Programme.
Given these examples, wouldn’t a red traffic light on certain food products be especially motivating for companies to reformulate their products to earn a yellow or green seal of approval?
Front-of-package food labelling is an opportunity for the food and beverage industry to do right by public health, whether they are mandated or choose to do so. But this will require a simple and thoughtful approach to labelling that will provide consumers with an honest evaluation of the healthfulness of a food product.