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Consumers’ understanding of front-of-pack labels on food packages: An exploratory mixed methods

 study in South Africa



 Melvi Todd , Timothy Guetterman , Elizabeth Joubert 1,3
       2
 1
 1 Department of Food Science, Stellenbosch University, Stellenbosch, South Africa;  2 Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, Unites States of America;  3 Plant Bioactives Group, Post-harvest and Agro-processing Technologies, Agricultural Research Council, Infruitec-Nietvoorbij, Stellenbosch, South Africa
 BACKGROUND  OBJECTIVE
 Food labels, and mainly the nutritional information, are difficult to decipher by many consumers. Formats include different types of nutrient summaries (e.g. scales or percentages) in a  The findings from an exploratory mixed methods study (qualitative interviews followed by quantitative consumer survey) could increase the value created by food labels in South Africa by
 range of designs, as well as warnings on labels. It is unclear which of these formats would be best understood by South African consumers, and therefore most beneficial to include on  providing policymakers with insights on the best way to communicate health information on the front of food packages.
 food packaging.
 OVERVIEW OF EXPLORATORY MIXED METHODS STUDY





















                        B                 D
 METHODS  10                                                     F
 The exploratory mixed-method design used in-depth interviews (n = 49; qualitative) to explore professional stakeholders’ suggestions for the improvement of food labels, followed by an
 online consumer survey (n = 1261; quantitative). Six front-of-pack (FOP) labels were applied to a fictitious cereal product, with the control product having no FOP label. Consumers  NONE
 evaluated the perceived healthiness of the control, compared to cereals with FOP labels. A mixed model ANOVA (Analysis of Variance) was used to compare differences in perceived  9  C
 healthiness between products with different front-of pack labels.  8  7.66  7.87  E
                                                                        (b)
 RESULTS (Figure 1)  7  7.16  (a)     6.96        (a)                   7.32   G
               (bc)
 Participants perceived the cereal with the health warning (Product G) as less healthy compared to the control (Product A; p<0.01). The product with the low health star rating (Product E)  (c)
 was also perceived to be less healthy than the control (p<0.01) whilst Product C, the “unhealthy” Guideline Daily Amount (GDA) label, was not perceived to be less healthy than the control  6  5.91
 (p=0.06). The cereal bearing a low GI health claim (Product D) was rated as healthier than the control (p<0.01), as was the cereal with the high health star rating (Product B; p<0.01). The
 “healthy” GDA (Product F) was not perceived to be healthier than the control (p=0.12).  HEALTHINESS RATING  HEALTHINESS RATING (1 = very unhealthy; 10 = very healthy)  5  (d)  4.37
 CONCLUSIONS  4                                                                     (e)
 GDA’s hold no nutritional guidance value to consumers in the South African context. In contrast, the label depicting a warning (Product G) performed best to indicate a less healthy
 nutritional profile, with the low health star rating (Product E) also being effective. Health claims increase the perceived healthiness of a product, although not to the same extent as  3
 warnings reduce the perceived healthiness. Health star ratings, as part of FOP labelling, hold promise to both discourage consumers from less healthy food purchases as well as to guide
 towards healthier choices. This tool should be further investigated for use in South Africa.  2
        1
 ACKNOWLEDGEMENTS  A       B           C          D           E          F          G
 1. Supervisors: Prof Elizabeth Joubert, Prof Gunnar Sigge & Prof Tim Guetterman
 2. Additional guidance & support: Prof Dalene de Beer, Prof Charlene Gerber & Dr Jako Volschenk   FRONT OF PACK LABELS (A = Control)
 3. Funding: NRF-DAAD (MND190508435061) & DSI (DST/CON 00029/2019)
  Figure 1 Healthiness rating of front of pack labels by consumers compared to Control (A). Different alphabetical letters (a-e) indicate significant differences (p<0.05) between labels (A-G).
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