title: Evaluation of consumer understanding of different front-of-package nutrition labels, 2010-2011.
abstract: BACKGROUND
  Governments throughout the world are using or considering various front-of-package (FOP) food labeling systems to provide nutrition information to consumers. Our web-based study tested consumer understanding of different FOP labeling systems.
  
  
  METHODS
  Adult participants (N = 480) were randomized to 1 of 5 groups to evaluate FOP labels: 1) no label; 2) multiple traffic light (MTL); 3) MTL plus daily caloric requirement icon (MTL+caloric intake); 4) traffic light with specific nutrients to limit based on food category (TL+SNL); or 5) the Choices logo. Total percentage correct quiz scores were created reflecting participants' ability to select the healthier of 2 foods and estimate amounts of saturated fat, sugar, and sodium in foods. Participants also rated products on taste, healthfulness, and how likely they were to purchase the product. Quiz scores and product perceptions were compared with 1-way analysis of variance followed by post-hoc Tukey tests.
  
  
  RESULTS
  The MTL+caloric intake group (mean [standard deviation], 73.3% [6.9%]) and Choices group (72.5% [13.2%]) significantly outperformed the no label group (67.8% [10.3%]) and the TL+SNL group (65.8% [7.3%]) in selecting the more healthful product on the healthier product quiz. The MTL and MTL+caloric intake groups achieved average scores of more than 90% on the saturated fat, sugar, and sodium quizzes, which were significantly better than the no label and Choices group average scores, which were between 34% and 47%.
  
  
  CONCLUSIONS
  An MTL+caloric intake label and the Choices symbol hold promise as FOP labeling systems and require further testing in different environments and population subgroups.
authors.affiliation: The Rudd Center for Food Policy and Obesity, Yale University, New Haven, CT 06511, USA. christina.roberto@yale.edu
authors.forename: Christina A
authors.initials: CA
authors.lastname: Roberto
authors.forename: Marie A
authors.initials: MA
authors.lastname: Bragg
authors.forename: Marissa J
authors.initials: MJ
authors.lastname: Seamans
authors.forename: Regine L
authors.initials: RL
authors.lastname: Mechulan
authors.forename: Nicole
authors.initials: N
authors.lastname: Novak
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Brownell
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003256:Community Participation / Q000523:psychology* / Q000706:statistics & numerical data; D003237:Connecticut; D002149:Energy Intake; D005260:Female; D005502:Food / Q000145:classification; D005515:Food Labeling / Q000379:methods*; D005518:Food Preferences / Q000523:psychology*; D058870:Food, Organic; D015438:Health Behavior; D006266:Health Education / Q000379:methods; D006302:Health Services Research; D006801:Humans; D008297:Male; D018673:Nutrition Policy; D009753:Nutritive Value; D015397:Program Evaluation