Pulse Brain · Growing Health Evidence Index
Tier 2 — RCT, large cohort or strong causal designPeer-reviewed

Effect of front-of-package information, fruit imagery, and high-added sugar warning labels on parent beverage choices for children: a randomized clinical trial

Musicus AA, Roberto CA, Moran AJ, Sorscher S, Greenthal E, Rimm EB

JAMA Netw Open 2022; 5: e2236384 · 2022

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Summary

This randomised trial examined how front-of-package labelling strategies affect parental beverage choices for children aged 0–5 years. Among 5005 US caregivers, high-added sugar warning labels—particularly when paired with teaspoon-of-sugar disclosures—significantly reduced both the proportion selecting high-added sugar beverages (6.4 percentage points) and the added sugar content of chosen drinks (−1.3 g; −14.2%). Removing marketing claims and fruit imagery also reduced high-added sugar beverage selection, whereas percentage juice disclosures had no significant effect on choice.

Regional applicability

The study was conducted in the United States and reflects US beverage labelling practices and parental behaviour. The findings are likely transferable to United Kingdom consumers where similar front-of-package marketing and added sugar labelling debates are ongoing; however, UK regulations already mandate front-of-package nutrition labels and may have different baseline awareness levels, potentially affecting the magnitude of warning label impact.

Key measures

Primary: type of beverage chosen (high-added sugar vs. other); added sugar content (grams); calories (kcal). Secondary: parental knowledge of added sugar and percentage juice; perceptions of beverages.

Outcomes reported

The study measured parental beverage choices for children aged 0-5 years across seven front-of-package labelling conditions, including the type of beverage selected and resulting added sugar (grams) and caloric content. Secondary outcomes included parental knowledge about added sugar and juice percentage, and perceptions of beverages.

Theme
Marketing, media & food environments
Subject
Food environments & consumer behaviour
Study type
Research
Study design
Randomized clinical trial
Source type
Peer-reviewed study
Status
Published
Geography
United States
System type
Food supply chain
DOI
10.1001/jamanetworkopen.2022.36384
Catalogue ID
IRmoq83nfm-6ef0dd

Topic tags

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