Food Labeling Clinical Trial
Official title:
Front of Pack Nutritional Labeling of Processed Foods Among Mexican Consumers
The effect of three front of pack (FOP) labeling schemes (Mexican Guideline Daily Amounts (GDA), Ecuador's Multiple Traffic Light (MTL) and Chilean Warning Labels (WL) in red) on purchasing intentions was evaluated using a randomized experiment of an online shopping simulation. The study employed an online grocery store developed for this purpose to simulate a shopping situation.
Nutrition labels may modify purchasing behavior. Different labels may influence consumer
purchasing behaviors in different ways.
In general, for nutrition labels to have any effect on purchasing decisions, consumers must
first be exposed to them and perceive the displayed information on the labels. Then, the
effect will be mediated by consumer understanding. Based on this understanding, consumers may
use the label to make inferences about the nutritional quality or healthiness of the product,
which, together with other information (e.g. trust or liking of the label or taste of the
product) may affect the evaluation of the product and eventually the purchase decision of the
product.
GDA provide numeric information on the content of key nutrients in the food product without
interpreting the information.
MTL and WL are nutrient-specific labels providing an interpretation of the nutritional
content of specific nutrients in the product. The MTL uses traffic light colors to indicate
the high (red) or low (green) content of key nutrients, whereas the WL are only included in a
product when the content of each key ingredient is above specific criteria.
Trained undergraduate student research assistants from eight universities across the country
recruited the study participants. Research assistants were trained on how to approach and
recruit participants and obtain informed consent. They were instructed to recruit 20 or more
participants each. Recruitment took place in public spaces previously selected by convenience
by the research team, based on their use by low- and middle-income groups in Mexico (i.e.,
public schools, public squares, public health centers, as well as supermarket chains and
shopping centers located in low-income neighborhoods). Potential participants were approached
by research assistants, who explained study objectives and invited them to be part of the
study. Then, individuals were screened for eligibility using a 3-item screener. To access
this screener, research assistants used a tablet or laptop with internet-access, to access a
unique web address where our web-based tool was hosted. Research assistants were
automatically informed by the web-based tool about the eligibility of the participant.
Informed consent was obtained from all eligible participants using an automated
computer-based form. Then, the tablet or laptop was handed to participants, who completed a
self-administered online demographic and health survey, and then accessed the online shopping
site to simulate a shopping situation. Participants completed the shopping task on the same
day at the public place where they were recruited.
After allocation, participants viewed a video explaining how to correctly interpret the
assigned label. Each participant was asked to shop freely, to better mimic real-world grocery
shopping conditions. Research assistants instructed participants as follows: "take into
account the assigned label and choose your preferred products". Participants were assigned an
initial budget to do their shopping, although they did not pay actual money for their
groceries. This budget corresponded to their weekly expenditure in groceries reported in the
demographic survey, from 500-5000 Mexican pesos ($28-280 USD), in multiples of 500. No
specific instructions were given related to the number or total cost of food products
purchased.
FOP nutrition labels were affixed on the food items of the virtual supermarket. The store
displayed the name, price and the front of the pack image of 60 food products from 5 food
groups (ready-made foods, dairy products, non-dairy beverages, salty snacks, and breakfast
cereals). Products were shown on traditional shopping shelves. Participants could zoom in to
look more closely at the products and their prices, and could click on the product to access
a new pop-up window. This new window displayed product information (i.e., name and brand), a
larger image of the front of the product packaging, and an area where they could select the
amount or number of products they wanted to put in their shopping cart. The pop-up window was
the only way in which participants could select the food products to "purchase". Participants
could also zoom in further on this pop-up to look more closely at the package and the
nutritional label.
After completing their shopping, participants revised their shopping cart and "purchased"
their products. A brief feedback on the nutritional quality of the products in their shopping
cart was provided as a retribution for their time.
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