Simplifying mental math: Changing how added sugars are displayed on the nutrition facts label can improve consumer understanding.
Proposed variations to Nutrition Facts Labels (NFL) have included the display of added sugars (AS) content, but its impact on consumer understanding is poorly understood.



To examine the degree to which different formats for displaying AS influence consumer understanding, perceptions, and purchase intentions.



Randomized-controlled online experiment.



A sample of 2509 U.S adults.



Participants were randomized to 1 of 8 conditions and viewed 10 food or beverage images with either: (1) no label (control); (2) the current NFL (without AS); (3) the proposed NFL without AS; or the proposed NFL with AS in (4) grams, (5) grams and teaspoons, (6) grams and percent Daily Value (%DV), (7) grams with high/medium/low text, or (8) grams with high/medium/low text and %DV.



ANCOVAs compared scores on quizzes that assessed the accuracy of judgments about AS, overall nutrition understanding and purchase intentions.



Presenting AS in grams plus high/medium/low text with and without %DV led to the highest AS understanding scores (85% and 83% correct, respectively) compared to 70% correct when AS was not on the label or was displayed in grams only (74% correct). Displaying AS in teaspoons did not significantly improve understanding beyond grams alone. Consumers were best able to determine which of two products was healthier when AS was presented as %DV (68% correct) versus displayed in grams alone (60% correct), but %DV did not differ from high/medium/low text or teaspoons. None of the labels influenced purchase intentions relative to no label.



Displaying AS on the NFL in grams with high/medium/low text, %DV, or the combination of the two, improved consumer understanding more than presenting it in grams or teaspoons.
University of Sao Paulo, Faculty of Public Health; Harvard T.H. Chan School of Public Health, Department of Nutrition, Brazil. Electronic address: Nek564@mail.harvard.edu.
Neha
N
Khandpur
Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523, United States. Electronic address: Dan.graham@colostate.edu.
Dan J
DJ
Graham
Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, 1105b Blockley Hall, Philadelphia, PA 04884, United States. Electronic address: Croberto@mail.med.upenn.edu.
Christina A
CA
Roberto
D000328:Adult; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D000073417:Dietary Sugars; D005260:Female; D005515:Food Labeling / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D020407:Internet; D008297:Male; D018673:Nutrition Policy; D014481:United States
D000073417:Dietary Sugars
Added sugars; Consumer understanding; Nutrition labels; Obesity; Purchase intentions