A Randomized Controlled Trial Evaluating the Relative Effectiveness of the Multiple Traffic Light and Nutri-Score Front of Package Nutrition Labels

The objective of this trial was to test two promising front-of-pack nutrition labels, 1) the United Kingdom’s Multiple Traffic Lights (MTL) label and 2) France’s Nutri-Score (NS), relative to a no-label control. We hypothesized that both labels would improve diet quality but NS w...

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Main Authors: Eric A. Finkelstein, Felicia Jia Ler Ang, Brett Doble, Wei Han Melvin Wong, Rob M. van Dam
Format: Article
Language:English
Published: MDPI AG 2019-09-01
Series:Nutrients
Subjects:
Online Access:https://www.mdpi.com/2072-6643/11/9/2236
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spelling doaj-78142715042a41c59bfb663bbbb8a7782020-11-25T01:35:56ZengMDPI AGNutrients2072-66432019-09-01119223610.3390/nu11092236nu11092236A Randomized Controlled Trial Evaluating the Relative Effectiveness of the Multiple Traffic Light and Nutri-Score Front of Package Nutrition LabelsEric A. Finkelstein0Felicia Jia Ler Ang1Brett Doble2Wei Han Melvin Wong3Rob M. van Dam4Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore 807443, SingaporeProgram in Health Services and Systems Research, Duke-NUS Medical School, Singapore 807443, SingaporeProgram in Health Services and Systems Research, Duke-NUS Medical School, Singapore 807443, SingaporeProgram in Health Services and Systems Research, Duke-NUS Medical School, Singapore 807443, SingaporeSaw Swee Hock School of Public Health, National University of Singapore, Singapore 807443, SingaporeThe objective of this trial was to test two promising front-of-pack nutrition labels, 1) the United Kingdom’s Multiple Traffic Lights (MTL) label and 2) France’s Nutri-Score (NS), relative to a no-label control. We hypothesized that both labels would improve diet quality but NS would be more effective due to its greater simplicity. We tested this hypothesis via an online grocery store using a 3 × 3 crossover (within-person) design with 154 participants. Outcomes assessed via within person regression models include a modified Alternative Healthy Eating Index (AHEI)-2010 (primary), average Nutri-Score, calories purchased, and singular measures of diet quality of purchase orders. Results show that both labels significantly improve modified AHEI scores relative to Control but neither is statistically superior using this measure. NS performed statistically better than MTL and Control based on average Nutri-Score, yet, unlike MTL it did not statistically reduce calories or sugar from beverages. This suggest that NS may be preferred if the goal is to improve overall diet quality but, because calories are clearly displayed on the label, MTL may perform better if the goal is to reduce total energy intake.https://www.mdpi.com/2072-6643/11/9/2236front-of-pack labelingnutrition labelingfood Intakediet qualitydietonline grocery storenutri-score5-color nutritional labelmultiple traffic lights
collection DOAJ
language English
format Article
sources DOAJ
author Eric A. Finkelstein
Felicia Jia Ler Ang
Brett Doble
Wei Han Melvin Wong
Rob M. van Dam
spellingShingle Eric A. Finkelstein
Felicia Jia Ler Ang
Brett Doble
Wei Han Melvin Wong
Rob M. van Dam
A Randomized Controlled Trial Evaluating the Relative Effectiveness of the Multiple Traffic Light and Nutri-Score Front of Package Nutrition Labels
Nutrients
front-of-pack labeling
nutrition labeling
food Intake
diet quality
diet
online grocery store
nutri-score
5-color nutritional label
multiple traffic lights
author_facet Eric A. Finkelstein
Felicia Jia Ler Ang
Brett Doble
Wei Han Melvin Wong
Rob M. van Dam
author_sort Eric A. Finkelstein
title A Randomized Controlled Trial Evaluating the Relative Effectiveness of the Multiple Traffic Light and Nutri-Score Front of Package Nutrition Labels
title_short A Randomized Controlled Trial Evaluating the Relative Effectiveness of the Multiple Traffic Light and Nutri-Score Front of Package Nutrition Labels
title_full A Randomized Controlled Trial Evaluating the Relative Effectiveness of the Multiple Traffic Light and Nutri-Score Front of Package Nutrition Labels
title_fullStr A Randomized Controlled Trial Evaluating the Relative Effectiveness of the Multiple Traffic Light and Nutri-Score Front of Package Nutrition Labels
title_full_unstemmed A Randomized Controlled Trial Evaluating the Relative Effectiveness of the Multiple Traffic Light and Nutri-Score Front of Package Nutrition Labels
title_sort randomized controlled trial evaluating the relative effectiveness of the multiple traffic light and nutri-score front of package nutrition labels
publisher MDPI AG
series Nutrients
issn 2072-6643
publishDate 2019-09-01
description The objective of this trial was to test two promising front-of-pack nutrition labels, 1) the United Kingdom’s Multiple Traffic Lights (MTL) label and 2) France’s Nutri-Score (NS), relative to a no-label control. We hypothesized that both labels would improve diet quality but NS would be more effective due to its greater simplicity. We tested this hypothesis via an online grocery store using a 3 × 3 crossover (within-person) design with 154 participants. Outcomes assessed via within person regression models include a modified Alternative Healthy Eating Index (AHEI)-2010 (primary), average Nutri-Score, calories purchased, and singular measures of diet quality of purchase orders. Results show that both labels significantly improve modified AHEI scores relative to Control but neither is statistically superior using this measure. NS performed statistically better than MTL and Control based on average Nutri-Score, yet, unlike MTL it did not statistically reduce calories or sugar from beverages. This suggest that NS may be preferred if the goal is to improve overall diet quality but, because calories are clearly displayed on the label, MTL may perform better if the goal is to reduce total energy intake.
topic front-of-pack labeling
nutrition labeling
food Intake
diet quality
diet
online grocery store
nutri-score
5-color nutritional label
multiple traffic lights
url https://www.mdpi.com/2072-6643/11/9/2236
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