title: Usage and Understanding of Serving Size Information on Food Labels in the United States.
abstract: OBJECTIVE
  To investigate consumer understanding and usage of serving size (SS) information on Nutrition Facts (NF) labels.
  
  
  METHODS
  We analyzed three data sources: (1) U.S. Food and Drug Administration (FDA) Health and Diet Survey (HDS) 1994 (n = 1945), 1995 (n = 1001), and 2008 (n = 2584); (2) National Health and Nutrition Examination Survey (NHANES) 2005-2006 and 2007-2008 (n = 10,750); and (3) 2011 FDA Nutrition Facts Label Experimental Study (NFLES) (n = 9493). Data from FDA are cross-sectional and we focused on usage and meaning of SS.
  
  
  METHODS
  United States.
  
  
  METHODS
  Adults (18+ years).
  
  
  METHODS
  Both HDS and NHANES addressed how often participants used SS information and HDS also asked how SS is determined. Both NHANES and NFLES contained similar questions on the meaning of SS but NFLES also included an open-ended response option.
  
  
  METHODS
  We included both quantitative and qualitative measures. Questions were analyzed by demographic variables and body mass index with frequencies, cross-tabulations, and χ(2) statistics reported.
  
  
  RESULTS
  HDS showed that the percentage of consumers who used SS information often or sometimes increased from 54% in 1994 to 64% in 2008. NHANES and NFLES data indicated that a majority of respondents had misinterpreted the meaning of SS. Women and obese individuals were more likely to use SS often or sometimes, but were also more likely to misinterpret the meaning of SS. A small subsample of NFLES participants expressed a distrust of the SS information.
  
  
  CONCLUSIONS
  There is a widespread misunderstanding about SS, suggesting the need for clearer NF labels or enhanced education efforts.
authors: Yuanting
authors: Y
authors: Zhang
authors: Mark A
authors: MA
authors: Kantor
authors: WenYen
authors: W
authors: Juan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004435:Eating / Q000523:psychology*; D005260:Female; D005515:Food Labeling; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D064788:Serving Size / Q000523:psychology*; D014481:United States; D055815:Young Adult
keywords: Manuscript format: research; Nutrition Education; Nutrition Label; Prevention Research; Research purpose: relationship testing; Serving Size; Survey Research; all U.S. locations; all income levels; all races/ethnicities; behavioral; Setting: United States; Health focus: nutrition; descriptive; Study design: survey research; policy; Target population age: adults; Target population circumstances: all education levels; qualitative; Outcome measure: cognitive; weight control; Strategy: education