The efficacy of calorie labelling formats on pre-packaged foods: an experimental study among adolescents and young adults in Canada.
Acton, Rachel B. ; Vanderlee, Lana ; White, Christine 等
The efficacy of calorie labelling formats on pre-packaged foods: an experimental study among adolescents and young adults in Canada.
Calories are the body's energy currency and are essential for
our regular function and performance. However, the consumption of
calories at levels above daily requirements is becoming increasingly
common due to a high availability of energy-dense foods and increasingly
large portion sizes, and has been positively associated with obesity and
its related diseases, including cardiovascular disease, diabetes,
musculoskeletal disorders and some cancers. (1) Daily energy
requirements vary significantly according to factors such as age, gender
and physical activity level, but there are clear guidelines outlined in
both Canada and the United States that identify each group's
approximate energy needs. (2,3)
In Canada, as similarly done in the US, (4) calorie information is
displayed in a Nutrition Facts table (NFT) on the labels of prepackaged
food items. (5) NFTs are an important source of nutrition information
for consumers: in 2008, over two thirds (68%) of Canadians reported
obtaining nutrition information from food labels, and more than half of
all Canadians (57%) report that they always or usually read the
nutrition label. (6) With respect to calories, 74% of Canadians consider
the total calories of a food item at least sometimes when choosing the
foods they eat. (6) Studies in the US have produced similar findings,
indicating that roughly half of American adults report using nutrition
labels in general when making food purchasing decisions, and
approximately 46% report "often" using calorie information
specifically. (7-10)
Health Canada and the US Food and Drug Administration (USFDA) have
recently proposed updates to nutrition labels on prepackaged foods,
including changes to the presentation of calorie information. (11,12)
The proposed modifications in both Canada and the US recommend
increasing the prominence of calorie information by using larger, bolded
font sizes. The effects of these proposed label changes have been
investigated only briefly in focus groups by the USFDA, and in an online
study by Lando and Lo that focused on examining dual-column Nutrition
Facts labels. (13,14) Both studies found that enlarged calorie
information had little effect among various other label alterations.
Additional studies have examined other measures to increase the use and
comprehension of nutrition labels, including the addition of
interpretive information, such as colours and symbols. (15) Overall,
there is relatively little evidence on alternative ways of communicating
calorie information on pre-packaged food nutrition labels.
The purpose of the current study was to experimentally test the
efficacy of various calorie labelling formats at improving recall of
calorie information and at portraying calorie content in the context of
total diet. The current study also examined use of calorie information
among young people, and their preferences for calorie labelling formats.
Young people are a key demographic for nutrition education in Canada, as
they report the poorest diet quality across all age groups, with high
total caloric intakes and high consumption of "other" foods
that are typically energy dense. (16,17)
METHODS
The study was conducted in August 2014 as a component of a larger
online experimental study among young people in Canada. Participants
aged 16-24 years were recruited from an online commercial panel (Nielsen
Consumer Insights Panel). A stratified random sample of Nielsen online
panelists were sent an e-mail invitation to complete the survey. Quotas
in the larger study were set such that there were an equal (50%) number
of females and males, and that 50% of participants were aged 16-18.
Participants residing outside of the Canadian provinces were excluded. A
total of 2,011 participants completed the survey; one participant was
excluded due to data quality concerns and two due to geographic region
being out of scope, for a final sample size of 2,008 participants.
Participants were provided with remuneration of approximately CAD
$2-$3 upon completion of the survey. Sample weights were constructed
using population estimates from the Canadian 2011 National Household
Survey (NHS) for age, gender and geographic region. (18) Although the
larger study recruited 50% of participants from youth ages 16-18 years,
the current study reweighted the sample based on 2011 NHS age category
data. Surveys were only offered in English, and participant consent was
obtained. Participants were encouraged to refrain from using Google,
smartphones, calculators or any other resources to assist with answering
survey questions. Ethical approval for the study was received from a
University of Waterloo Research Ethics Committee.
Protocol
The study consisted of one item examining participants' use of
calorie information and other nutrition information on the NFT, two
experimental tasks examining the efficacy of various calorie labelling
formats, and a discrete-choice task examining consumer preferences for
calorie labelling formats, in addition to socio-demographic
characteristics.
Socio-demographic Measures
Participants reported their age, gender, ethnicity, and
self-reported height and weight to calculate body mass index (BMI).
Province of residence was provided by the survey firm, and was grouped
into five regions: British Columbia (BC), Prairies (Alberta,
Saskatchewan, Manitoba), Ontario, Quebec, and Atlantic Canada (Nova
Scotia, Newfoundland and Labrador, New Brunswick, Prince Edward Island).
Use of Calorie Information
Participants were asked "When you look at the Nutrition Facts
table on a food package either in the store or at home, how often do you
usually look at the following information?" This item was asked of
calories, serving size, sodium, fat, saturated fat, trans fat,
cholesterol, carbohydrates, sugars, fibre, protein, vitamin A, vitamin
C, iron, calcium and % daily value (%DV). The response options available
to the participants included "never", "rarely",
"sometimes", "often", "always",
"don't know" and "refuse".
Task 1
Task 1 examined the efficacy of formats for calorie labelling.
Participants were randomized into a 2 (font size) x 6 (calorie format)
between-subjects factorial design. Participants were randomized to view
an NFT with calorie information displayed in either the current font
size used by Health Canada, or in a font approximately three times as
large. Each NFT featured one of the following six attributes: 1) the
current Canadian Nutrition Facts table with no additional changes to the
calorie information; 2) calorie information with a %DV based on a 2000
kcal diet;3) calorie information plus "High/Haut" or
"Low/Bas" text descriptors; 4) calorie information plus an
infographic showing how much of a 2000 kcal diet was in one serving of
the product; 5) the current NFT with a Reference Daily Intake (RDI)
statement at the bottom describing that the %DVs are based on a 2000
calorie diet; or 6) calorie information plus a traffic light symbol
displaying high, medium or low calorie content. These six formatting
conditions were selected as a result of discussions with Health Canada
surrounding evidence from the existing literature and their potential
changes to NFTs in Canada. See Figure 1 for the six NFT conditions with
calorie information displayed in the large font size.
Participants were told to look at the NFT, which was displayed for
10 seconds before it was removed from the screen. After being shown the
image for 10 seconds, participants were taken to the next screen and
asked to recall how many calories were in one serving of the product,
with an open-ended response. The correct response for every condition
was 400 calories.
Task 2
To examine comprehension of calorie information in the context of
daily recommended limits, the same NFT as in Task 1 was returned to the
screen, and participants were asked "How many servings of this
product would equal your recommended daily value for calories?"
with an open-ended response. The correct response was approximately five
servings, which would be the equivalent of a 2000 kcal diet.
Task 3
Task 3 used a discrete-choice task to examine consumer preferences
for displaying calorie information. Participants were shown two NFTs
side by side, one with calorie information in a small font (current
Nutrition Facts table) and one with calorie information in a large font,
as shown in Figure 2. The position of the NFTs (i.e., left side of
screen vs. right side of screen) was randomized. Participants were then
shown the six calorie conditions seen in Figure 1 with calorie
information either in small or large font, according to their preference
for font size indicated in the previous question. Participants were
asked which label had the most useful information on calories.
Analysis
Statistical analyses were conducted using SPSS software (version
22.0;IBM Corp., Armonk, NY, USA;2014). Chi-square tests were used to
test for socio-demographic differences between experimental conditions.
McNemar chi-square tests were used to test differences in proportions.
For Task 1 and 2, separate logistic regression models were fitted
to examine the effect of labelling condition on correct responses (1 =
correct, 0 = incorrect/don't know). Both outcomes were tested using
chi-square tests to identify whether there were significant differences
according to font size; if so, regression models were stratified by font
size. For Task 1, there was a significant difference in font size, and
thus separate models were run for small font and large font. The model
included an indicator variable for labelling condition (current, %DV
only, high/low information, infographic, RDI, traffic light) to examine
individual contrasts. An additional model was conducted with indicator
variables for font size and labelling condition, and included an
interaction term (font size x labelling condition) to examine
differences in the efficacy of the various labelling conditions with
small and large font. For Task 2, there was no significant difference
between font size, and the model was not stratified. The model included
an indicator variable for labelling condition. All analyses were
conducted using sample weights, with the exception of the sample table,
for which unweighted data are reported.
RESULTS
Study sample
Sample characteristics can be found in Table 1. There were no
significant differences in socio-demographic measures among the
experimental conditions in either of Tasks 1 or 2.
Perceptions of calories
More than half (62.0%) of participants reported looking at calorie
information "often" or "always" when they looked at
the NFT on a food package either in the store or at home. Calories were
the nutrient most commonly looked at "often" or
"always", and were looked at significantly more than the next
most commonly viewed nutrients, which included total fat (54.8% of
participants; [chi square] = 45.09, p < 0.001), sugars (54.5%; [chi
square] = 43.00, p < 0.001), serving size (52.0%; [chi square] =
77.42, p < 0.001) and sodium (50.8%; [chi square] = 93.79, p <
0.001).
Task 1
Overall, just over half of the sample (50.9%) correctly recalled
that the product contained 400 calories. Participants were significantly
more likely to recall the number of calories in the product when
calories were displayed in a large font compared to small font (61% vs.
42%, [chi square] = 66.67, p < 0.001).
There was an overall effect of labelling condition for both small
and large font, as shown in Figure 3 ([chi square] = 28.41, p < 0.001
and [chi square] = 37.12, p < 0.001 for small and large font
respectively). Statistically significant contrasts among conditions are
represented by matching letters in Figure 3. In the small font
condition, the traffic light condition performed better than all the
other conditions: those who saw the traffic light condition were more
likely to respond correctly than those who saw the current labelling
condition (OR = 2.47, 95% CI 1.61-3.80, p < 0.001), the %DV condition
(OR = 2.15, 95% CI 1.37-3.38, p = 0.001), the high/low condition (OR =
2.66, 95% CI 1.70-4.18, p < 0.001), the RDI condition (OR = 2.53, 95%
CI 1.64-3.90, p < 0.001) and the infographic condition (OR = 1.79,
95% CI 1.16-2.76, p = 0.009).
In the large font condition, those who saw the currentcondition
were more likely to respond correctly than those in the %DV condition
(OR = 2.00, 95% CI 1.28-3.13, p = 0.002), the high/low condition (OR =
2.84, 95% CI 1.82-4.43, p < 0.001) and the infographic condition (OR
= 1.66, 95% CI 1.07-2.60, p = 0.025). Those in the RDI condition were
more likely to respond correctly than those in the %DV condition (OR =
1.96, 95% CI 1.26-3.04, p = 0.003), the high/low condition (OR = 2.77,
95% CI 1.78-4.31, p < 0.001) and the infographic condition (OR =
1.62, 95% CI 1.05-2.52, p = 0.031). Those in the infographic condition
were more likely to respond correctly than those in the high/low
condition (OR = 1.71, 95% CI 1.10-2.65, p = 0.017). Finally, those in
the traffic light condition were more likely to respond correctly than
those in the %DV condition (OR = 1.92, 95% CI 1.22-3.03, p = 0.005), the
high/low condition (OR = 2.72, 95% CI 1.72-4.29, p < 0.001) and the
infographic condition (OR = 1.59, 95% CI 1.012.51, p = 0.045).
In the model including an interaction term, the interaction between
font size and condition was significant ([chi square] = 21.09, p =
0.001). Compared to the difference between small and large font in the
currentcondition, there was significantly less difference between font
sizes in the %DV condition (OR = 2.30, 95% CI 1.22-4.32, p = 0.01), the
high/low condition (OR = 2.63, 95% CI 1.40-4.96, p = 0.003), the
infographic condition (OR = 2.30, 95% CI 1.23-4.28, p = 0.009) and the
traffic light condition (OR = 2.58, 95% CI 1.37-4.84, p = 0.003).
Task 2
In Task 2, the same NFT as in Task 1 was returned to the screen,
and participants were asked to identify the number of servings of the
product that would equal their recommended daily value for calories.
Overall, 43.0% of the sample answered this question correctly.
There were no significant differences in font size. As shown in
Figure 4, there was a significant effect of calorie format on correct
responses ([chi square] = 178.27, p < 0.001). Participants who saw
the %DV condition were more likely to respond correctly than those in
the current condition (OR = 2.78, 95% CI 2.03-3.82, p < 0.001), the
high/low condition (OR = 2.78, 95% CI 2.00-3.85, p < 0.001), the RDI
condition (OR = 2.42, 95% CI 1.77-3.30, p < 0.001) and the traffic
light condition(OR = 2.88,95%CI2.09-3.99, p < 0.001).Those who saw
the infographic condition were significantly more likely to respond
correctly compared to those in the current condition (OR = 5.37, 95% CI
3.87-7.46, p < 0.001), the %DV condition (OR = 1.93, 95% CI
1.39-2.69, p < 0.001), the high/low condition (OR = 5.36, 95% CI
3.82-7.52, p < 0.001), the RDI condition (OR = 4.66, 95% CI
3.37-6.45, p<0.001) and the traffic light condition (OR = 5.57, 95%
CI 3.98-7.79, p < 0.001).
Task 3
When shown the small font (current Nutrition Facts table) and large
font calorie information side by side, significantly more participants
found the large font version the more useful (66.8% vs. 33.2%, p <
0.001). When asked which of the six calorie conditions had the most
useful information on calories, there were significant differences in
the number of participants who selected each condition as most useful
([chi square] = 2539.69, p < 0.001). The condition most commonly
cited as most useful was the infographic condition (47%), followed by
the traffic light (26%), %DV (14%), RDI (8%), current (2%), high/low
(2%) and "Don't know" (1%).
DISCUSSION
The current study demonstrates that increased font size and novel
labelling formats can improve recall and comprehension of calorie
content among young people. The young people in this study looked at
calorie information more than any other nutrient displayed in the NFT,
suggesting that calorie information is important to this population,
even more so than "hot topic" nutrients such as sodium and
sugars.
When asked to recall information they had seen only briefly, larger
font size was more salient to participants. The calorie labelling
formats performed differently within each font size condition, with the
traffic light symbol being most effective with the small font size, and
Canada's current NFT with no additional changes being most
effective with the large font size, followed closely by the RDI and
traffic light conditions. The high performance of the traffic light
symbol in this study is consistent with previous research suggesting
that traffic light labels improve attentional capture and increase
consumers' understanding and correct interpretation of nutrient
levels in food products. (19,20) The high performance of Canada's
current NFT with the large font size may be explained by the fact that
participants were shown NFT's that included additional and
unfamiliar information with only a limited time for review. The
conditions with lower performance all contained additional information
in the calories heading, which may have distracted attention from the
calorie number and led to poor performance in the recall task. The brief
exposure to the nutrition information in this task was intentionally
selected to replicate how consumers may interact with this information
in a natural setting, where they may only glance briefly at nutrition
information. Maximizing the salience of calorie information through
large font size may be particularly important in the "real
world" retail setting, with time pressures and many competing
factors for consumers' attention.
Both the %DV and infographie formats, which provide contextual
information immediately beside calorie information, helped young people
comprehend calorie information in the context of daily recommended
limits better than Canada's existing format and the other calorie
labelling formats. The RDI statement performed fairly poorly, even in
Task 2 when it would be expected to help the most with consumers'
comprehension of calories in context of daily recommended limits. This
may be due to its placement at the bottom of the NFT. Findings from
previous eye tracking research have shown that consumers are less likely
to view components located near the bottom of an NFT; most people stop
reading after the first few lines. (21) These results may be indicative
of what can be expected from Canada's recommendations to introduce
a footnote explaining %DV at the bottom of the NFT, as well as the
similar footnote currently used and proposed to be updated on the US
nutrition labels. (11,12)
Policy-makers should be clear on the desired outcome of a policy
when considering new calorie labelling formats. If the goal is to
increase attentional capture and recall of calorie information among
consumers, it may help to increase the font size or to add coloured
symbolic formatting such as a traffic light symbol. If a policy aims to
increase consumer understanding of how a particular food product's
caloric content fits into the context of a total diet, then using the
infographic or %DV formats may be important. The infographic format,
which was also identified as most useful by respondents in this study,
may be the best option to capture both of these goals.
Limitations and strengths
This survey was performed on a sample of adolescents and young
adults, and therefore may not be applicable to other populations. The
results of this study are also limited to six specific labelling
formats, and therefore may exclude other possible formatting approaches.
Further limitations of the study include a non-probability-based sample,
and the use of an online survey, which may not represent how consumers
naturally interact with nutrition labels in a real-world setting.
Despite limitations of the online survey, it also allowed the
display of real food images, the manipulation of these images for each
NFT, and randomization of participants to groups. Additional strengths
of this study include a sample weighted for age, gender and geographic
region based on the Canadian 2011 NHS, and the use of a between-subjects
experimental design.
CONCLUSIONS
Overall, the results suggest a potential benefit from increased
font size and prescriptive labelling formats for calorie content in
packaged food products. Improving the prominence and comprehensibility
of calorie content on food labels can aid consumers in making better
food purchasing decisions, and make it easier for them to better tailor
their calorie consumption to that of a healthy diet.
The findings from this study have implications for food labelling
policies. The current study was developed for Canadian NFTs; however,
many of the modifications can also be applied to the nutrition labels of
the US and other jurisdictions. The enlarged font size used in this
study is similar to that proposed in the US. (12) In Canada,
stakeholders have expressed concern that too great a focus on calories
could detract from other important factors when choosing healthy foods,
therefore the proposed font size increase is not to the same extent as
that used in this study. (22) Despite concerns over the emphasis on
calories, excess energy intake remains the primary determinant in
population-level changes in obesity. In addition, more consumers seek
calorie information from NFTs than any other type of information. Future
research should compare varying increases in calorie font size in order
to find a balance between calorie information that is noticeable and
comprehensible, without detracting from the other important nutrients
displayed on the NFT. In addition, future research should assess
differences in label use and effectiveness between categories of key
demographic variables such as age, gender and BMI. The findings of this
study, including the notable performance of the prescriptive labelling
formats, can help to direct labelling policy decisions in Canada, as
well as any other country considering changes to nutrition labels.
REFERENCES
(1.) World Health Organization. Fact sheet No. 311: Obesity and
overweight, 2015. Available at:
http://www.who.int/mediacentre/factsheets/fs311/en (Accessed January 13,
2016).
(2.) Health Canada. Estimated energy requirements, 2014. Available
at: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/basics-base/1_1_1-eng.php (Accessed January 13, 2016).
(3.) U.S. Department of Agriculture & U.S. Department of Health
and Human Services. Dietary guidelines for Americans, 2010. Available
at: http://www. cnpp.usda.gov/sites/default/files/dietary_guidelines_for_americans/PolicyDoc. pdf (Accessed January 13, 2016).
(4.) U.S. Food and Drug Administration. How to understand and use
the nutrition facts label, 2015. Available at: http://www.fda.gov/Food/
IngredientsPackagingLabeling/LabelingNutrition/ucm274593.htm (Accessed
January 13, 2016).
(5.) Government of Canada. Understanding food labels: Calories,
2012. Available at: http://healthycanadians.gc.ca/eating-nutrition/label-etiquetage/understandingcomprendre/table_calories-eng.php (Accessed
January 13, 2016).
(6.) Canadian Council of Food and Nutrition. Tracking nutrition
trends VII, 2008. Available at:
https://www.cfdr.ca/Downloads/CCFN-docs/C1180--TNT-VIIFINAL-REPORT--full-report-Sept-1.aspx (Accessed January 13, 2016).
(7.) U.S. Food and Drug Administration. 2008 Health and diet
survey: Topline frequency report, 2015. Available at:
http://www.fda.gov/Food/
FoodScienceResearch/ConsumerBehaviorResearch/ucm193895.htm (Accessed
January 13, 2016).
(8.) Blitstein JL, Evans WD. Use of nutrition facts panels among
adults who make household food purchasing decisions. J Nutr Educ Behav
2006;38(6):360-64. PMID: 17142192. doi: 10.1016/j.jneb.2006.02.009.
(9.) Byrd-Bredbenner C, Alfieri L, Kiefer L. The nutrition label
knowledge and usage behaviours of women in the US. Nutr Bull
2000;25(4):315-22. doi: 10. 1046/j.1467-3010.2000.00070.x.
(10.) Ollberding NJ, Wolf RL, Contento I. Food label use and its
relation to dietary intake among US adults. J Am Diet Assoc
2010;110(8):1233-37. PMID: 20656100. doi: 10.1016/j.jada.2010.05.007.
(11.) Government of Canada. Commitment to consult with Canadians on
improving food labels, 2015. Available at:
http://healthycanadians.gc.ca/
alt/pdf/health-system-systeme-sante/consultations/food-label-etiquette-desaliments/process-processus-eng.pdf (Accessed January 13, 2016).
(12.) U.S. Food and Drug Administration. Proposed changes to the
Nutrition Facts label, 2015. Available at:
http://www.fda.gov/Food/GuidanceRegulation/
GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm385663. htm
(Accessed January 13, 2016).
(13.) U.S. Food and Drug Administration. Calories count: Report of
the working group on obesity, 2004.
http://www.fda.gov/Food/FoodScienceResearch/
ConsumerBehaviorResearch/ucm081770.htm (Accessed January 13, 2016).
(14.) 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(2):241-50. PMID: 23351627. doi:
10.1016/j.jand.2012.11.006.
(15.) Roberto CA, Khandpur N. Improving the design of nutrition
labels to promote healthier food choices and reasonable portion sizes.
Int J Obes (Loud) 2014;38(Suppl 1):S25-33. doi: 10.1038/ijo.2014.86.
(16.) Garriguet D. Diet quality in Canada. Health Rep
2009;20(3):41-52. PMID: 19813438.
(17.) Garriguet D. Canadians' eating habits. Health Rep
2007;18(2):17-32. PMID: 17578013.
(18.) Statistics Canada. NHS profile, 2011. Census program
(database), 2011. Available at:
https://www12.statcan.gc.ca/nhs-enm/2011/dp-pd/prof/index. cfm?Lang=E
(Accessed January 13, 2016).
(19.) Ares G, Gimenez A, Bruzzone F, Antunez L, Sapolinski A, Vidal
L, et al. Attentional capture and understanding of nutrition labelling:
A study based on response times. Int J Food Sci Nutr 2012;63(6):679-88.
PMID: 22273500. doi: 10.3109/09637486.2011.652598.
(20.) Food Standards Agency. Quantitative evaluation of alternative
food signposting concepts, 2005. Available at:
http://webarchive.nationalarchives.gov.uk/
20131104005023/http://www.food.gov.uk/multimedia/pdfs/signpostquanresearch.pdf (Accessed January 13, 2016).
(21.) Graham DJ, Jeffery RW. Location, location, location:
Eye-tracking evidence that consumers preferentially view prominently
positioned nutrition information. J Am Diet Assoc 2011;111(11):1704-11.
PMID: 22027053. doi: 10.1016/j.jada.2011.08.005.
(22.) Government of Canada. Regulations amending the food and drug
regulations nutrition labelling, other labelling provisions and food
colours. Canada Gazette 2015;149(24).
Received: February 10, 2016
Accepted: April 24, 2016
Rachel B. Acton, BSc, [1] Lana Vanderlee, PhD, [1,2] Christine
White, MSc, [1] David Hammond, PhD [1]
Author Affiliations
[1.] School of Public Health and Health Systems, University of
Waterloo, Waterloo, ON
[2.] Department of Nutritional Sciences, University of Toronto,
Toronto, ON
Correspondence: David Hammond, PhD, Associate Professor, School of
Public Health and Health Systems, University of Waterloo, 200 University
Avenue W, Waterloo, ON N2L 3G1, Tel: 519-888-4567, ext. 36462, E-mail:
david.hammond@ uwaterloo.ca
Conflict of Interest: David Hammond has provided paid expert
testimony on behalf of public health authorities in response to legal
challenges from the food and beverage industry.
Table 1. Sample characteristics of the actual non-weighted
sample who completed the online survey and were
included in the sample (N = 2008)
Characteristic % (n)
Gender
Male 49.9% (1001)
Female 50.1% (1007)
Age (years)
16-18 50.0% (1004)
19-21 25.0% (503)
22-24 25.0% (501)
Ethnicity
White 58.4% (1173)
Other 38.4% (771)
Not stated 3.2% (64)
Region
BC 18.3% (368)
Prairies (AB, SK, MB) 23.3% (468)
Ontario 41.8% (839)
Quebec 6.2% (124)
Atlantic provinces 8.6% (173)
(NS, NB, PEI, NL)
Not stated 1.8% (36)
BMI (kg/[m.sup.2])
<18.5 (underweight) 10.4% (209)
18.5-24.9 (normal weight) 56.2% (1129)
25.0-29.9 (overweight) 14.8% (297)
30+ (obese) 7.0% (140)
Not reported 11.6% (233)
likely to respond correctly than those in
the high/low condition
Figure 1. Nutrition Facts table conditions with
calorie information in large font
Current
Nutrition Facts
Valeur nutritive
Per 1 tray (320g) / pour 1 plat (320g)
Calories / Calories 400
Amount % Daily Value
Teneur % valeur quotidienne
Fat /Lipides 15 g 23 %
Saturated / satures 7 g 38 %
+ Trans /trans 0.5 g
Cholesterol / Cholesterol 45 mg
Sodium / Sodium 880 mg 37 %
Carbohydrate / Glucides 43 g 14 %
Fibre / Fibres 5 g 20 %
Sugars / Sucres 6 g
Protein / Proteines 24 g
Vitamin A / Vitamine A 15 %
Vitamin C / Vitamine C 15 %
Calcium / Calcium 25 %
Iron / Fer 20 %
RDI Statement
Nutrition Facts
Valeur nutritive
Per 1 tray (320g) / pour 1 plat (320g)
Calories / Calories 400
Amount % Daily Value
Teneur % valeur quotidienne
Fat / Lipides 15 g 23 %
Saturated / satures 7 g 38 %
+ Trans / trans 0.5 g
Cholesterol / Cholesterol 45 mg
Sodium / Sodium 880 mg 37 %
Carbohydrate / Glucides 43 g 14 %
Fibre / Fibres 5 g 20 %
Sugars / Sucres 6 g
Protein / Proteines 24 g
Vitamin A / Vitamine A 15 %
Vitamin C / Vitamine C 15 %
Calcium / Calcium 25 %
Iron / Fer 20 %
Percent Daily Values are based on a 2.000
calorie diet. Your values may be higher or
lower depending on your calorie needs
% DV
Nutrition Facts
Valeur nutritive
Per 1 tray (320g) / pour 1 plat (320g)
Calories 400 20%
Amount % Daily Value
Teneur % valeur quotidienne
Fat / Lipides 15 g 23 %
Saturated / satures 7 g 38%
+ Trans / trans 0.5 g
Cholesterol / Cholesterol 45 mg
Sodium / Sodium 880 mg 37%
Carbohydrate / Glucides 43 g 14 %
Fibre / Fibres 5 g 20 %
Sugars / Sucres 6 g
Protein / Proteines 24 g
Vitamin A / Vitamine A 15 %
Vitamin C / Vitamine C 15 %
Calcium / Calcium 25%
Iron / Fer 20 %
Infographie
Nutrition Facts
Valeur nutritive
Per 1 tray (320g) / pour 1 plat (320g)
Calories / Calories 400
Based on a 2.000 calorie diet
Amount % Daily Value
Teneur % valeur quotidienne
Fat / Lipides 15 g 23 %
Saturated / satures 7 g 38 %
+ Trans / trans 0.5 g
Cholesterol / Cholesterol 45 mg
Sodium / Sodium 880 mg 37 %
Carbohydrate / Glucides 43 g 14%
Fibre/Fibres 5 g 20 %
Sugars / Sucres 6 g
Protein / Proteines 24 g
Vitamin A / Vitamine A 15 %
Vitamin C / Vitamine C 15 %
Calcium / Calcium 25%
Iron / Fer 20 %
'High/Low' text descriptors
Nutrition Facts
Valeur nutritive
Per I tray (320g) ! pour I plat (320g)
Calories 400 low/bas
Amount % Daily Value
Teneur % valeur quotidienne
Fat / Lipides 15 g 23%
Saturated / satures 7 g
+ Trans / trans 0.5 g
Cholesterol/Cholesterol 45 mg
Sodium / Sodium 880 mg 37%
Carbohydrate / Glucides 43 g 14%
Fibre/Fibres 5 g 20%
Sugars / Sucres 6 g
Protein / Proteines 24 g
Vitamin A ! Vitamine A 15 %
Vitamin C / Vitamine C 15 %
Calcium / Calcium 25 %
Iron / Fer 20 %
Traffic light symbol
Nutrition Facts
Valeur nutritive
Per 1 tray (320g) / pour 1 plat (320g)
Calories / Calories 400
Amount % Daily value
Teneur % valeur quotidienne
Fat / Lipides 15 g 23%
Saturated / satures 7 g 38 %
+ Trans / trans 0.5 g
Cholesterol / Cholesterol 45 mg
Sodium / Sodium 880 mg 37 %
Carbohydrate / Glucides 43 g 14 %
Fibre / Fibres 5 g 20 %
Sugars / Sucres 6 g
Protein / Proteines 24 g
Vitamin A / Vitamine A 15%
Vitamin C / Vitamine C 15%
Calcium / Calcium 25%
Iron Fer 20%
Figure 2. Current Nutrition Facts tables with calorie information
in small and large font
Nutrition Facts
Valeur nutritive
Per 1 tray (320g) / pour 1 plat (320g)
Amount % Daily Value
Teneur % valeur quotidienne
Calories / Calories 400
Fat / Lipides 15 g 23 %
Saturated / satures 7 g 38 %
+ Trans/trans 0.5 g
Cholesterol / Cholesterol 45 mg
Sodium / Sodium 880 mg 37%
Carbohydrate / Glucides 43 g 14 %
Fibre/Fibres 5 g 20 %
Sugars / Sucres 6 g
Protein / Proteines 24 g
Vitamin A / Vitamine A 15 %
Vitamin C / Vitamine C 15 %
Calcium / Calcium 25 %
Iron / Fer 20 %
Nutrition Facts
Valeur nutritive
Per 1 tray (320g) / pour 1 plat (320g)
Calories /Calories 400
Amount % Daily Value
Teneur % valeur quotidienne
Fat / Lipides 15 g 23 %
Saturated / satures 7 g 38 %
+ Trans/trans 0.5 g
Cholesterol / Cholesterol 45 mg
Sodium / Sodium 880 mg 37 %
Carbohydrate / Glucides 43 g 14 %
Fibre/Fibres 5 g 20 %
Sugars / Sucres 6 g
Protein / Proteines 24 g
Vitamin A / Vitamine A 15%
Vitamin C / Vitamine C 15 %
Calcium / Calcium 25 %
Iron / Fer 20 %
Figure 3. Percentage of respondents who correctly recalled calorie
amounts in each labelling condition. "How many calories are in one
serving of this product?" * Values with the same letters are
significantly different at the p < 0.05 level (e.g., "a" denotes
that the current labelling condition with small font produced
significantly different recall in respondents than the traffic light
condition with small font)
Small font Large font
Current 36.5% (a) 68.8% (f,g,h)
%DV 39.8% (b) 52.5% (f,i,m)
High/low 34.8% (c) 43.8% (g,j,l,n)
RDI 36.0% (d) 68.3% (i,j,k)
Infographic 44.3% (e) 57.1% (h,j,l,o)
Traffic Light 58.7% 67.9% (m,n,o)
(a,b,c,d,e)
Note: Table made from bar graph.
Figure 4. Percentage of respondents who correctly identified
the number of servings per RDI (small and large fonts
combined). "How many servings of this product
would equal your recommended daily value for
calories?" * Values with the same letters are
significantly different at the p < 0.001 level
Current 32.3% (a,e)
%DV 57.0% (a,b,c,d,f)
High/low 32.3% (b,g)
RDI 35.4% (c,h)
Infographic 71.9% (e,f,g,h,i)
Traffic Light 31.5% (d,i)
Note: Table made from bar graph.
COPYRIGHT 2016 Canadian Public Health Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2016 Gale, Cengage Learning. All rights reserved.