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Front-of-pack nutritional labels: Understanding by low- and middle-income Mexican consumers


Autoři: Jorge Vargas-Meza aff001;  Alejandra Jáuregui aff001;  Selene Pacheco-Miranda aff001;  Alejandra Contreras-Manzano aff001;  Simón Barquera aff001
Působiště autorů: Center Health and Nutrition Research, National Institute of Public Health, Cuernavaca, México aff001
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0225268

Souhrn

Front-of-pack labeling is a cost-effective strategy to decrease population consumption of sodium, sugar, saturated fat, total fat, and trans-fatty acids, considered critical nutrients for chronic disease. Our main objective was to explore the subjective understanding of labels that are currently used internationally among low- and middle-income Mexican consumers. We performed two phases of 10 focus groups with adolescents (13–15 y), young adults (21–23 y), mothers of children 3–12 y, fathers of children 3–12 y and older adults (55–70 y). Seven FOPL were evaluated: Guideline Daily Amounts, Multiple Traffic Light, Chilean Warning labels, Warning labels in Red, 5-Color Nutrition Label, Health Star Rating, and Healthy Choice label. Data was analyzed with a triangulation of researchers using a content analysis, based on three codes: 1) awareness and use of the Guideline Daily Amounts, 2) acceptability, and 3) subjective understanding of labels. Most participants were aware of the Guideline Daily Amounts, however they rarely used it because interpreting the information displayed on the label was too complicated. Health Star Rating, Warning labels, Multiple Traffic Light and the Healthy Choice logo labels were the most understandable, however the acceptability of the The Healthy Choice logo decreased as it did not provide information on specific ingredients. The Warning labels was the only label able to warn about critical nutrients that could represent a health risk. The Warning labels in red was more accepted compared to Warning labels in black. Results show that directive and semi-directive labels, such as Warning labels, Health Star Rating or Multiple Traffic Light, may be better at helping population of low- and middle income make healthier food choices, than non-directive FOPL such as the Guideline Daily Amounts implemented in México. The study results highlight the potential of Warning labels to support decreases in the consumption of critical ingredients in low- and middle-income Mexican consumers.

Klíčová slova:

Food – Socioeconomic aspects of health – Fats – Food consumption – Latin American people – Mexican people – Nutrients


Zdroje

1. Grunert KG, Wills JM. A review of European research on consumer response to nutrition information on food labels. J Public Health (Bangkok). 2007;15:385–99.

2. Van Trijp HC. Consumer understanding and nutritional communication: key issues in the context of the new EU legislation. Eur J Nutr. 2009;48:s41–8. doi: 10.1007/s00394-009-0075-1 19937441

3. Hawkes C, Jewell J, Allen K. A food policy package for healthy diets and the prevention of obesity and diet-related non-communicable diseases: The NOURISHING framework. Obes Rev. 2013;14:159–68. doi: 10.1111/obr.12098 24103073

4. Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D. Tackling of unhealthy diets, physical inactivity, and obesity: Health effects and cost-effectiveness. Lancet. 2010;376:20–6. doi: 10.1016/S0140-6736(10)61045-8

5. Rivera JA, Barquera S, González-Cossío T, Olaiz G, Sepúlveda J. Nutrition transition in Mexico and in other Latin American countries. Nutr Rev. 2004;62 (Supplement 2):S149–57.

6. Barquera S, White M. Treating Obesity Seriously in Mexico: Realizing, Much Too Late, Action Must Be Immediate. Obesity. 2018;26:1530–1. doi: 10.1002/oby.22296 30277025

7. Pauline D, Caroline M, Chantal J, Emmanuelle KG, Mathilde T, Léopold F, et al. Effectiveness of front-of-pack nutrition labels in french adults: Results from the nutrinet-santé cohort study. PLoS One. 2015;10:1–15. doi: 10.1371/journal.pone.0140898 26509679

8. Ecuador. Ministerio de Salud Pública. Reglamento de Etiquetado de Alimentos Procesados para el Consumo Humano. Acuerdo No. 00004522. 2013;0:17.

9. Nutrient Profile Model. Washington, D.C.: PanAmerican Health Organization; 2016.

10. Sánchez K, Bladeras N, Munguía A, Barquera S. El etiquetado de alimentos y bebidas: la experiencia en México. México; 2018. https://www.insp.mx/epppo/blog/4680-etiquetado.html

11. Julia C, Hercberg S. Development of a new front-of-pack nutrition label in France: the five-colour Nutri-Score. Public Heal Panor. 2017;3:712–25.

12. Health NZM of. Health Star Rating System. 2016. http://healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/guide-for-industry-document Accessed 10 Dec 2017.

13. DOF. Reglamento sanitario de los alimentos. Diario Oficcial de la República N°4193. 2015. http://web.minsal.cl/sites/default/files/decreto_etiquetado_alimentos_2015.pdf Accessed 30 Jan 2016.

14. Cecchini M, Warin L. Impact of food labelling systems on food choices and eating behaviours: A systematic review and meta-analysis of randomized studies. Obes Rev. 2016;17:201–10. doi: 10.1111/obr.12364 26693944

15. Maubach N, Hoek J, Mather D. Interpretive front-of-pack nutrition labels. Comparing competing recommendations. Appetite. 2014;Nov:67–77.

16. De la Cruz-Góngora V, Torres P, Contreras-Manzano A, Jáuregui de la Mota A, Mundo-Rosas V, Villalpando S, et al. Understanding and acceptability by Hispanic consumers of four front-of-pack food labels. Int J Behav Nutr Phys Act. 2017;14:1–12. doi: 10.1186/s12966-016-0456-9

17. Arrúa A, MacHín L, Curutchet MR, Martínez J, Antúnez L, Alcaire F, et al. Warnings as a directive front-of-pack nutrition labelling scheme: Comparison with the Guideline Daily Amount and traffic-light systems. Public Health Nutr. 2017;20:2308–17. doi: 10.1017/S1368980017000866 28625228

18. Arrúa A, Curutchet MR, Rey N, Barreto P, Golovchenko N, Sellanes A, et al. Impact of front-of-pack nutrition information and label design on children’s choice of two snack foods: Comparison of warnings and the traffic-light system. Appetite. 2017;116:139–46. doi: 10.1016/j.appet.2017.04.012 28428151

19. Ducrot P, Méjean C, Julia C, Kesse-Guyot E, Touvier M, Fezeu LK, et al. Objective understanding of front-of-package nutrition labels among nutritionally at-risk individuals. Nutrients. 2015;7:7106–25. doi: 10.3390/nu7085325 26305255

20. Nieto C, Jauregui A, Contreras-Manzano AG, Arillo-Santillán E, Barquera S, White C, et al. Understanding of food labeling systems among White, Latinos, and Mexican population: Data from the International Food Policy Study 2017. Int J Behav Nutr Phys Act. 2019;(submitted.

21. Egnell M, Talati Z, Hercberg S, Pettigrew S, Julia C. Objective understanding of front-of-package nutrition labels: An international comparative experimental study across 12 countries. Nutrients. 2018;10.

22. Cowburn G, Stockley L. Consumer understanding and use of nutrition labelling: a systematic review. Public Health Nutr. 2005;8:21–8. doi: 10.1079/phn2005666 15705241

23. Vyth EL, Steenhuis IHM, Brandt HE, Roodenburg AJC, Brug J, Seidell JC. Methodological quality of front-of-pack labeling studies: A review plus identification of research challenges. Nutr Rev. 2012;70:709–20. doi: 10.1111/j.1753-4887.2012.00535.x 23206284

24. Nielsen J. Usability Engineering. New York,NY Acad Press. 1993.

25. Julia C, Hercberg S. Nutri-Score : Evidence of the effectiveness of the French front-of-pack nutrition label. Ernahrungs Umschau. 2017;64:181–7.

26. Diario Oficial de la Federación. Lineamientos por los que se dan a conocer los criterios nutrimentales y de publicidad que deberán observar los anunciantes de alimentos y bebidas no alcohólicas para publicitar sus productos en televisión abierta y restringida, así como en salas de exhibi. 2014. http://www.dof.gob.mx/nota_detalle.php?codigo=5340694&fecha=15/04/2014 Accessed 26 Jul 2016.

27. Ministerio de Salud de Ecuador. Rotulado de Productos Alimenticios. Ecuador; 2014. http://www.normalizacion.gob.ec/wp-content/uploads/downloads/2014/08/RTE-022-1R.pdf Accessed 26 Jul 2016

28. Roodenburg AJC, 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;65:1190–200. doi: 10.1038/ejcn.2011.101 21697817

29. Andreú J. Las técnicas de Análisis de Contenido: una revisión actualizada. Fund Cent Estud Andaluces. 2002;:1–34. doi: 10.2307/334486

30. Strauss A, Corbin J. Bases de la Investigación Cualitativa: Técnicas y procedimientos para desarrollar la teoría fundamentada. Primera ed. Colombia: Sage Publications, Inc.; 2002.

31. Morse JM. Critical Analysis of Strategies for Determining Rigor in Qualitative Inquiry. Qual Health Res. 2015;25:1212–22. doi: 10.1177/1049732315588501 26184336

32. Liamputtong P. Qualitative Research methods. Oxford. 4th edition. Australia; 2016.

33. Cortés F, Escobar A, Gonzáles de la rocha M. Método Científico y política social: a propósito de lss evaluaciones cualitativas de los programas sociales. 1st edition. México, D.F.; 2008.

34. Secretaría de Salud. Estrategia nacional para la prevención y el control del sobrepeso, la obesidad y la diabetes. Secr Salud. 2013;:105. doi: 10.1017/CBO9781107415324.004

35. UK Health Forum (2018). Public health and the food and drinks industry: The governance and ethics of interaction. Lessons from research, policy and practice. London: UKHF.

36. Stern D, Tolentino L, Barquera S. Revisión del etiquetado frontal: análisis de las Guías Diarias de Alimentación (GDA) y su comprensión por estudiantes de nutrición en México. Inst Nac Salud Publica. 2011.

37. Tolentino-mayo L, C M, Patiño SR, C M, Bahena-espina L, Ed M, et al. Conocimiento y uso del etiquetado nutrimental de alimentos y bebidas industrializados en México. 2018;60.

38. Díaz A, Veliz P, Rivas G, Mafla C, Martínez L, Vaca C. Etiquetado de alimentos en Ecuador: implementación, resultados y acciones pendientes Investigación original. Rev Panam Salud Publica. 2017;41:1–7.

39. Freire WB, Waters WF, Rivas-Mariño G. Semáforo nutricional de alimentos procesados: Estudio cualitativo sobre conocimientos, comprensión, actitudes y prácticas en el Ecuador. Rev Peru Med Exp Salud Publica. 2017;34:11–8. doi: 10.17843/rpmesp.2017.341.2762 28538841

40. Helfer P, Shultz TR. The effects of nutrition labeling on consumer food choice: A psychological experiment and computational model. Ann N Y Acad Sci. 2014;1331:174–85. doi: 10.1111/nyas.12461 24913496

41. Corvalán C, Reyes M, Garmendia ML, Uauy R. Structural responses to the obesity and non-communicable diseases epidemic: Update on the Chilean law of food labelling and advertising. Obes Rev. 2019;20:367–74. doi: 10.1111/obr.12802 30549191

42. Hersey JC, Wohlgenant KC, Arsenault JE, Kosa KM, Muth MK. Effects of front-of-package and shelf nutrition labeling systems on consumers. Nutr Rev. 2013;71:1–14. doi: 10.1111/nure.12000 23282247

43. Wartella E, Lichtenstein A, Lindsay A. Front-of-Package Nutrition Rating Systems and Symbols: Promoting Healthier Choices. Adv Nutr. 2012;3:332–3. doi: 10.3945/an.112.001933

44. INEGI. Instituto Nacional de Estadística y Geografía. http://www.inegi.org.mx/ Accessed 15 Jan 2018.

45. Grunert KG, Bolton LE, Raats MM. Processing and acting upon nutrition labeling on food : The state of knowledge and new directions for transformative consumer research Nutrition Labeling in the USA and EU : An Overview. 2008;2030:1–40.

46. Talati Z, Pettigrew S, Kelly B, Ball K, Dixon H, Shilton T. Consumers’ responses to front-of-pack labels that vary by interpretive content. Appetite. 2016;101:205–13. doi: 10.1016/j.appet.2016.03.009 26970293

47. Becker MW, Sundar RP, Bello N, Alzahabi R, Bix L, Lansing E, et al. Assessing Attentional Prioritization of Front-of-Pack Nutrition Labels using Change Detection. 2016;:90–9.

48. Corporate Research Associates Inc.. Creative Concept Testing for Health Warning Messages. Final Report. Canadá; 2005. http://tobacco.cleartheair.org.hk/wp-content/uploads/2017/03/Canada-2005-Creative-Concept-Testing-for-Health-Warning-Messages-HC-Govt-Report.pdf Accessed Jul 28 2016

49. Hall MG, Sheeran P, Noar SM, Ribisl KM, Boynton MH, Brewer NT. A brief measure of reactance to health warnings. J Behav Med. 2017;40:520–9. doi: 10.1007/s10865-016-9821-z 28120228

50. Cho YJ, Thrasher JF, Yong HH, Szklo AS, O’Connor RJ, Bansal-Travers M, et al. Path analysis of warning label effects on negative emotions and quit attempts: A longitudinal study of smokers in Australia, Canada, Mexico, and the US. Soc Sci Med. 2018;197:226–34. doi: 10.1016/j.socscimed.2017.10.003 29096946

51. Mantzari E, Vasiljevic M, Turney I, Pilling M, Marteau T. Impact of warning labels on sugar-sweetened beverages on parental selection: An online experimental study. Prev Med Reports. 2018;12:259–67.

52. Diepeveen S, Ling T, Suhrcke M, Roland M, Marteau TM. Public acceptability of government intervention to change health-related behaviours: A systematic review and narrative synthesis. BMC Public Health. 2013;13:1. doi: 10.1186/1471-2458-13-1

53. Claudio Aqueveque (Escuela de Negocios UAI, Camila Corvalán (INTA U de C, María Luisa Garmendia (INTA U de C, Sonia Olivares (INTA U de C, Marcela Reyes (INTA U de C, Isabel Zacarías (INTA U de C. Estudio sobre evaluación de mensajes de advertencia de nutrientes críticos en el rotulado de alimentos. Santiago, Chile; 2012.

54. Acton R, Hammond D. Do Consumers Think Front-of-Package “High in” Warnings are Harsh or Reduce their Control? A Test of Food Industry. Obes (Silver Spring). 2018;Nov; 26 (11):1687–91.

55. Mazza MC, Dynan L, Siegel RM, Tucker AL. Nudging Healthier Choices in a Hospital Cafeteria: Results From a Field Study. Health Promot Pract. 2018;19:925–934. doi: 10.1177/1524839917740119 29169270


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