title: Consumer understanding and use of nutrition labelling: a systematic review.
abstract: OBJECTIVE
  To explore published and unpublished research into consumer understanding and use of nutrition labelling which is culturally applicable in Europe.
  
  
  METHODS
  A systematic review undertaken between July 2002 and February 2003.
  
  
  RESULTS
  One hundred and three papers were identified that reported on consumer understanding or use of nutrition labelling, most originating from North America or northern Europe. Only a few studies (9%) were judged to be of high or medium-high quality. We found that reported use of nutrition labels is high but more objective measures suggest that actual use of nutrition labelling during food purchase may be much lower. Whether or not consumers can understand and use nutrition labelling depends on the purpose of the task. Available evidence suggests that consumers who do look at nutrition labels can understand some of the terms used but are confused by other types of information. Most appear able to retrieve simple information and make simple calculations and comparisons between products using numerical information, but their ability to interpret the nutrition label accurately reduces as the complexity of the task increases. The addition of interpretational aids like verbal descriptors and recommended reference values helps in product comparison and in putting products into a total diet context.
  
  
  CONCLUSIONS
  Improvements in nutrition labelling could make a small but important contribution towards making the existing point-of-purchase environment more conducive to the selection of healthy choices. In particular, interpretational aids can help consumers assess the nutrient contribution of specific foods to the overall diet.
authors.affiliation: British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK. gill.cowburn@dphpc.ox.ac.uk
authors.forename: Gill
authors.initials: G
authors.lastname: Cowburn
authors.forename: Lynn
authors.initials: L
authors.lastname: Stockley
mesh_terms: D003142:Communication; D004032:Diet / Q000523:psychology / Q000592:standards*; D005502:Food / Q000592:standards; D005515:Food Labeling / Q000592:standards* / Q000706:statistics & numerical data*; D006077:Government Agencies; D006266:Health Education / Q000379:methods; D006801:Humans; D007881:Legislation, Food; D018673:Nutrition Policy; D052756:Nutritional Sciences / Q000193:education