Front-of-pack nutrition labeling: What is the best design to identify ‘healthy’ options?

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Source: Getty/ clubfoto (Getty Images)

Americans are more likely to choose the healthiest food when calories and dietary fiber are included along with nutrients-to-limit on the front of the package and when interpretive language – but not colors – provide extra context, according to research from the International Food Information Council (IFIC) published weeks before FDA’s self-imposed June deadline for proposing a rulemaking to standardize front-of-pack nutrition labels.

An online study including 3,000 Americans aged 18 to 80 years commissioned by IFIC published this month found significantly more participants correctly selected the “healthiest” front of package (FOP) label when it included calories and dietary fiber along with added sugars, saturated fat and sodium than when the FOP label variations included variations of the FDA Nutrition Info and FDA Nutrition Info with daily value information.

In addition, “use of interpretive language (ie, ‘Low,’ ‘Med’ and ‘High’) may facilitative more correct selection of the ‘least healthy’ FOP label when less nutrition information is provided,” but not when FOP labels include the most information, including added sugars, saturated fat and sodium along with calories and dietary fiber, IFIC concludes in its study, Front-Of-Package (FOP) Nutrition Labeling: Front & Center Food Information To Encourage Healthy Choices, published May 24.

FOP rulemaking based on FDA research could come as early as June

IFIC commissioned the research in partnership with Greenwald Research at the same time FDA has undertaken qualitative and quantitative consumer research to develop a standard FOP nutrition labeling scheme to help consumers interpret the nutrient information on food products.

The agency’s research includes testing consumer understanding of several different designs – some of which IFIC included in its study. These include a black-and-white and stoplight-colored designs similar to the existing Facts Up Front system created by FMI – The Food Industry Association and the Consumer Brands Association in the fall of 2011, which earned limited support from the agency and criticism from the Center for Science in the Public Interest.

FDA also tested two other groups of images. The first included Nutrition Tips boxes that characterize saturated fat, sodium, added sugar, fiber and calcium as low, medium or high – some of which included stoplight color coding or percent of daily value per serving. The second group included boxes that simply said "High In" and listed nutrients of concern with and without the percent daily value per serving.

FDA initiated its research after the Biden-Harris Administration directed it to study and propose a standardized, science-based FOP nutrition labeling system to help consumers, “particularly those with low nutrition literacy,” more easily identify healthy foods.

According to the Unified Agenda published last fall, FDA anticipates publishing its findings and proposing a FOP rulemaking by June.

The idea of a mandatory FOP labeling scheme triggered mixed emotions with some industry stakeholders arguing it could inadvertently hurt consumers, some public health advocates roundly supporting the idea and others expressing worry that FOP labeling could discourage consumers from reviewing the full Nutrition Facts panel on the back or side of packages.

No single FOP scheme was more effective

After conducting five experimental tests of several FOP schemes with an even distribution of respondents from high and low nutrition literacy groups, IFIC found overall no single FOP was better in helping consumers identify the healthiest and least healthy choices.

However, it found some elements may help consumers more than other elements.

For example, it found that labels with color lowered participants’ perceptions of a food’s healthfulness with some people assuming products with colorful labels were less healthy than nutritionally identical products with black and white labels.

It also found participants' concern about products with a medium level of added sugar, saturated fat and sodium was lower when the percent Daily Value was included on the FOP compared to schemes with variations of the FDA Nutrition Information on front of pack.

A positive framework may also be more useful for consumers, according to IFIC’s research, which found 89% of participants correctly selected the healthiest FOP label compared to 81% who correctly chose the least healthy label.

Finally, the research suggested FOP callouts of nutrients of interest may be more useful than a "healthy" symbol, which FDA also is creating as part of a broader reassessment of the definition of healthy.

“The presence of a prototype FDA [Guideline Daily Amount] FOP scheme on a 100% orange juice product image positively impacted perceptions of healthfulness more than a FDA 'Healthy' symbol prototype, even among people that say they are more likely to purchase a food that has a symbol or image on the package indicating that it is healthy,” according to IFIC.