| Literature DB >> 25922942 |
Lisa M Soederberg Miller1, Diana L Cassady2, Laurel A Beckett2, Elizabeth A Applegate3, Machelle D Wilson2, Tanja N Gibson1, Kathleen Ellwood4.
Abstract
Front-of-package nutrition symbols (FOPs) are presumably readily noticeable and require minimal prior nutrition knowledge to use. Although there is evidence to support this notion, few studies have focused on Facts Up Front type symbols which are used in the US. Participants with varying levels of prior knowledge were asked to view two products and decide which was more healthful. FOPs on packages were manipulated so that one product was more healthful, allowing us to assess accuracy. Attention to nutrition information was assessed via eye tracking to determine what if any FOP information was used to make their decisions. Results showed that accuracy was below chance on half of the comparisons despite consulting FOPs. Negative correlations between attention to calories, fat, and sodium and accuracy indicated that consumers over-relied on these nutrients. Although relatively little attention was allocated to fiber and sugar, associations between attention and accuracy were positive. Attention to vitamin D showed no association to accuracy, indicating confusion surrounding what constitutes a meaningful change across products. Greater nutrition knowledge was associated with greater accuracy, even when less attention was paid. Individuals, particularly those with less knowledge, are misled by calorie, sodium, and fat information on FOPs.Entities:
Mesh:
Year: 2015 PMID: 25922942 PMCID: PMC4414362 DOI: 10.1371/journal.pone.0125306
Source DB: PubMed Journal: PLoS One ISSN: 1932-6203 Impact factor: 3.240
Fig 1Front-of-Package (FOP) symbols for cereals (top) and frozen entrées (bottom).
Characteristics of Study Participants.
| Variable | N | Mean (SD) or percent % |
|---|---|---|
|
| 345 | 35.6 (9.1) |
|
| 345 | 27.5 (7.9) |
|
| 387 | 38.2 (28.2) |
|
| 387 | 63.1 (19.4) |
|
| 392 | 49.9 (16.5) |
|
| 392 | 15.8 (2.5) |
|
| 392 | 16.5 (3.4) |
|
| 392 | 60.0% |
|
| 390 | 28.1 (6.4) |
|
| 390 | |
| White | 74.0% | |
| African American | 9.7% | |
| Other | 16.3% | |
|
| 389 | |
| Less than $10,000 | 4.9% | |
| $10,000 to $14,999 | 6.4% | |
| $15,000 to $24,999 | 6.2% | |
| $25,000 to $34,999 | 8.7% | |
| $35,000 to $49,999 | 14.4% | |
| $50,000 to $74,999 | 19.3% | |
| $75,000 to $99,999 | 18.0% | |
| $100,000 to $149,999 | 15.2% | |
| $150,000 to $199,999 | 4.6% | |
| $200,000 or more | 2.3% |
Average proportion dwell times by Front-of-Package nutrition types for Cereals.
P-values are Tukey-Kramer adjusted for multiple comparisons.
| Cereals | Mean Proportion Dwell Time | St. dev. | p-values for all pair-wise comparisons |
|---|---|---|---|
| Calories | 0.061 | 0.027 | |
| Fat | 0.062 | 0.021 | |
| Fiber | 0.051 | 0.025 | <0.001 |
| Vitamin D | 0.018 | 0.012 | |
| Sodium | 0.091 | 0.031 | |
| Sugar | 0.073 | 0.028 |
Average proportion dwell times by Front-of-Package nutrition types for entrées.
P-values are Tukey-Kramer adjusted for multiple comparisons.
| Entrées | Mean Proportion Dwell Time | St. dev. | p-values for all pair-wise comparisons |
|---|---|---|---|
| Calories | 0.11 | 0.035 | |
| Fat | 0.099 | 0.032 | <0.001 |
| Fiber | 0.067 | 0.028 |
Estimated effects of dwell time on accuracy, tested separately for each area of interest (AOI) for cereals.
| Cereals | FOP AOI tested in model | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Calories | Fat | Fiber | Sodium | Sugar | Vitamin D | |||||||
| Covariate | Est | P | Est | P | Est | P | Est | P | Est | P | Est | P |
| Proportion Dwell Time on FOP AOI | -3.7 | <.001 | -3.1 | <.001 | 4.8 | <.001 | -1.05 | .035 | 2.9 | <.001 | 1.81 | .17 |
| Nutrition Knowledge (points) | 1.5 | .001 | 1.8 | <.001 | .90 | .036 | 1.9 | <.001 | 1.2 | .014 | 1.6 | .001 |
| Sex (male = 1) | 3.2 | .3 | 5.2 | .10 | .9 | .75 | 4.2 | .19 | 2.3 | .44 | 3.2 | .31 |
| Age (years) | -.3 | .004 | -.10 | .14 | -.2 | .08 | -.14 | .16 | -.2 | .04 | -.2 | .06 |
| Education (years) | .52 | .43 | .70 | .33 | 0.5 | .44 | 0.64 | .36 | .5 | .48 | .68 | .33 |
| Income (bracket, see | 2.0 | .009 | 1.9 | .01 | 1.1 | .14 | 1.9 | .02 | 1.4 | .07 | 1.7 | .034 |
| BMI (points) | -.04 | 0.86 | -.08 | .74 | -0.01 | .96 | -0.1 | .68 | .07 | .75 | .011 | .64 |
Estimates (Est) represent the change in percent accuracy for each unit change in the covariate. Units for the covariates are shown in parentheses. P-values <0.05 were considered statistically significant.
Estimated effects of dwell time on accuracy, tested separately for each area of interest (AOI) for entrées, and adjusted for covariates.
| Entrées | FOP AOI tested in model | |||||
|---|---|---|---|---|---|---|
| Calories | Fat | Fiber | ||||
| Covariate | Est | p | Est | p | Est | p |
| Proportion Dwell Time on FOP AOI | -.25 | .99 | -.75 | .13 | 2.4 | <.001 |
| Nutrition Knowledge (points) | 1.1 | .001 | 1.1 | <.001 | .71 | .03 |
| Sex (male = 1) | 6.5 | .003 | 6.9 | .002 | 5.29 | .01 |
| Age (years) | -.05 | .48 | -.04 | .56 | -.04 | .53 |
| Education (years) | .23 | .63 | .24 | .61 | .17 | .72 |
| Income (bracket) | 1.2 | .03 | 1.3 | .02 | .87 | .10 |
| BMI (points) | .30 | .07 | .30 | .08 | .23 | .14 |
Estimates (Est) represent the change in percent accuracy for each unit change in the covariate. Units for the covariates are shown in parentheses. P-values <0.05 were considered statistically significant.