Summary
BACKGROUND: Front-of-package labels (FOPLs) indicating high content of nutrients of concern (i.e., added sugars, sodium, and saturated fat) have the potential to improve consumer understanding of a food's healthfulness. The Food and Drug Administration (FDA) tested potential FOPLs, including "High-In" designs. METHODS: Participants (N = 3,931) were randomized to a control "High-In" FOPL with no icon (based on an FDA design) or 1 of 4 "High-In" FOPLs with icons: a (1) magnifying glass, (2) exclamation mark in a black circle, (3) exclamation mark in a white circle, and (4) multiple labels (one for each nutrient) with exclamation marks. Participants were shown 3 frozen meals, high in 1, 2, or 3 nutrients of concern, labeled according to assigned condition. Participants were asked to select the (1) healthiest and least healthy products and (2) the product(s) high in each of added sugars, sodium, and saturated fat. Perceived discouragement of consuming a food high in nutrients of concern was also assessed for each label. RESULTS: There were no significant differences between the control and icon labels in identifying the healthiest or least healthy products. However, the multilabel-exclamation condition improved identification of high-sodium and high-saturated-fat items compared to all other conditions (78 % vs. 68-72 % and 85 % vs. 76-80 %, respectively) (Ps < 0.05). The multilabel-exclamation condition was also perceived as significantly more discouraging of consuming a high-in food than all other conditions. CONCLUSION: FOPLs that list each "high-in" nutrient in separate labels may better help consumers identify foods high in nutrients of concern than a label combining all nutrients.
Outcomes reported
Referenced by Lancet Public Health FOPL RCT as citation 17; likely supports topic area: front-of-package labelling / warning labels; methods / modelling / statistics. Topics: front-of-package labelling / warning labels; methods / modelling / statistics Evidence type: Trial / experiment Source report: Lancet Public Health FOPL RCT Ref#: Lancet Public Health FOPL RCT #17 Original: Lemmon B, Musicus AA, Grummon AH, et al. “High-In” front-ofpackage labeling of foods high in added sugars, sodium, and saturated fat: a randomized experiment. Appetite 2026; 216: 108308.
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