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Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Nutrition | Research

Investigation of the 1-week effect of traffic light nutrition labeling on diet selection among Japanese university students: a randomized controlled trial

Authors: Nobuyuki Wakui, Raini Matsuoka, Kotoha Ichikawa, Chikako Togawa, Aika Okami, Shoko Kawakubo, Hinako Kagi, Mai Watanabe, Yuika Tsubota, Miho Yamamura, Yoshiaki Machida

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

The method of displaying nutrition information labels on the front of food packaging (FOP: Front of Pack) has been implemented worldwide to prevent lifestyle-related diseases. This study aimed to investigate whether the use of the UK’s Traffic Light Food (TLF) label, known as the FOP label, influences the dietary choices of Japanese youth and promotes healthy dietary choices.

Methods

Diet selection was performed for one week each during the baseline and intervention periods. During the intervention period, TLF labels were displayed on meal images of the intervention group. Participants chose what they would like to have for dinner of the day from 15 images. Each meal was scored based on the color of the nutrition label, and a comparison between groups was made to determine whether TLF labeling influenced meal selection for dinner. The psychological stress caused by the presence or absence of nutrition labels and nutritional components when choosing meals was also evaluated.

Results

A total of 69 participants were randomly assigned to two groups. Dietary choice scores indicated that the TLF-labeled group made significantly healthier dietary choices than the unlabeled group. Additionally, the TLF-labeled group showed a significant increase in the percentage of people conscious of nutritional components when choosing meals. Furthermore, a significant increase in the number of people conscious of protein, a nutritional ingredient not indicated on the TLF label, was observed. During the test period, no difference in psychological stress caused by the presence and absence of the TLF labels was observed.

Conclusions

The use of TLF labels also encouraged healthy dietary choices among Japanese university students. The use of FOP nutrition labels should be considered in Japan to prevent lifestyle-related diseases through healthy dietary choices.

Trial registration

UMIN Clinical Trials Registry Number: UMIN000047268. Registered March 23, 2022.
Literature
1.
go back to reference Risk NCD, Factor Collaboration. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016 April 2;387:1377-96. https://doi.org/10.1016/S0140-6736(16)30054-X (National Council on Disability. RisC). Erratum in: Lancet. 2016;387:1998. doi:10.1016/S0140-6736(16)30071-X, PubMed: 27203777. Risk NCD, Factor Collaboration. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016 April 2;387:1377-96. https://​doi.​org/​10.​1016/​S0140-6736(16)30054-X (National Council on Disability. RisC). Erratum in: Lancet. 2016;387:1998. doi:10.1016/S0140-6736(16)30071-X, PubMed: 27203777.
6.
go back to reference Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010 December 2;363:2211-9. 10.1056/NEJMoa1000367. Erratum in: N Engl J Med. 2011 September 1;365:869, PubMed: 21121834, PubMed Central: PMC3066051. Berrington de Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010 December 2;363:2211-9. 10.1056/NEJMoa1000367. Erratum in: N Engl J Med. 2011 September 1;365:869, PubMed: 21121834, PubMed Central: PMC3066051.
8.
go back to reference Kitahara CM, Flint AJ, Berrington de Gonzalez A, Bernstein L, Brotzman M, MacInnis RJ et al. Association between class III obesity (BMI of 40–59 kg/m2) and mortality: a pooled analysis of 20 prospective studies. PLOS Med 2014 July 8;11:e1001673. https://doi.org/10.1371/journal.pmed.1001673, PubMed: 25003901, PubMed Central: PMC4087039. Kitahara CM, Flint AJ, Berrington de Gonzalez A, Bernstein L, Brotzman M, MacInnis RJ et al. Association between class III obesity (BMI of 40–59 kg/m2) and mortality: a pooled analysis of 20 prospective studies. PLOS Med 2014 July 8;11:e1001673. https://​doi.​org/​10.​1371/​journal.​pmed.​1001673, PubMed: 25003901, PubMed Central: PMC4087039.
16.
go back to reference Asp NG, Bryngelsson S. Health claims in the labelling and marketing of food products:: the Swedish food sector’s Code of Practice in a European perspective. Scand J Food Nutr. 2007 September;51:107–26. doi:10.1080/17482970701652203, PubMed Central: PMC2606978. Asp NG, Bryngelsson S. Health claims in the labelling and marketing of food products:: the Swedish food sector’s Code of Practice in a European perspective. Scand J Food Nutr. 2007 September;51:107–26. doi:10.1080/17482970701652203, PubMed Central: PMC2606978.
17.
go back to reference Vyth EL, Steenhuis IH, Mallant SF, Mol ZL, Brug J, Temminghoff M et al. A front-of-pack nutrition logo: a quantitative and qualitative process evaluation in the Netherlands. J Health Commun. 2009 October-November;14:631– 45. https://doi.org/10.1080/10810730903204247, PubMed: 19851915. Vyth EL, Steenhuis IH, Mallant SF, Mol ZL, Brug J, Temminghoff M et al. A front-of-pack nutrition logo: a quantitative and qualitative process evaluation in the Netherlands. J Health Commun. 2009 October-November;14:631– 45. https://​doi.​org/​10.​1080/​1081073090320424​7, PubMed: 19851915.
20.
go back to reference Corvalán C, Correa T, Reyes M, Paraje G. The impact of the Chilean law on food labelling on the food production sector. Food and Agriculture Organization of the United Nations (FAO) and Institute of Nutrition and Food Technology of the Universidad De Chile. 2021;86. https://doi.org/10.4060/cb3298en. Corvalán C, Correa T, Reyes M, Paraje G. The impact of the Chilean law on food labelling on the food production sector. Food and Agriculture Organization of the United Nations (FAO) and Institute of Nutrition and Food Technology of the Universidad De Chile. 2021;86. https://​doi.​org/​10.​4060/​cb3298en.
29.
go back to reference Teran S, Hernandez I, Freire W, Leon B, Teran E. Use, knowledge, and effectiveness of nutritional traffic light label in an urban population from Ecuador: a pilot study. Global Health 2019 March 29;15:26. https://doi.org/10.1186/s12992-019-0467-9, PubMed: 30922324, PubMed Central: PMC6440007. Teran S, Hernandez I, Freire W, Leon B, Teran E. Use, knowledge, and effectiveness of nutritional traffic light label in an urban population from Ecuador: a pilot study. Global Health 2019 March 29;15:26. https://​doi.​org/​10.​1186/​s12992-019-0467-9, PubMed: 30922324, PubMed Central: PMC6440007.
31.
go back to reference Finkelstein EA, Ang FJL, Doble B, Wong WHM, van Dam RM. A randomized controlled trial evaluating the relative effectiveness of the multiple traffic light and nutri-score front of package nutrition labels. Nutrients 2019 September 17;11:2236. https://doi.org/10.3390/nu11092236, PubMed: 31533256, PubMed Central: PMC6770629. Finkelstein EA, Ang FJL, Doble B, Wong WHM, van Dam RM. A randomized controlled trial evaluating the relative effectiveness of the multiple traffic light and nutri-score front of package nutrition labels. Nutrients 2019 September 17;11:2236. https://​doi.​org/​10.​3390/​nu11092236, PubMed: 31533256, PubMed Central: PMC6770629.
32.
go back to reference Sonnenberg L, Gelsomin E, Levy DE, Riis J, Barraclough S, Thorndike AN. A traffic light food labeling intervention increases consumer awareness of health and healthy choices at the point-of-purchase. Prev Med:253-7. https://doi.org/10.1016/j.ypmed.2013.07.001. Epub 2013 Jul 13. Erratum in: Prev Med. 2014 February;59:86. doi:10.1016/j.ypmed.2013.11.014, PubMed: 23859926, PubMed Central: PMC3913274. Sonnenberg L, Gelsomin E, Levy DE, Riis J, Barraclough S, Thorndike AN. A traffic light food labeling intervention increases consumer awareness of health and healthy choices at the point-of-purchase. Prev Med:253-7. https://​doi.​org/​10.​1016/​j.​ypmed.​2013.​07.​001. Epub 2013 Jul 13. Erratum in: Prev Med. 2014 February;59:86. doi:10.1016/j.ypmed.2013.11.014, PubMed: 23859926, PubMed Central: PMC3913274.
34.
go back to reference Morley B, Scully M, Martin J, Niven P, Dixon H, Wakefield M. What types of nutrition menu labelling lead consumers to select less energy-dense fast food? An experimental study. Appetite. 2013 August;67:8–15. Epub 2013 Mar 22. PubMed. Morley B, Scully M, Martin J, Niven P, Dixon H, Wakefield M. What types of nutrition menu labelling lead consumers to select less energy-dense fast food? An experimental study. Appetite. 2013 August;67:8–15. Epub 2013 Mar 22. PubMed.
41.
go back to reference Wakui N, Matsuoka R, Togawa C, Ichikawa K, Kagi H, Watanabe M et al. Effectiveness of displaying traffic light food labels on the front of food packages in Japanese university students: a randomized controlled trial. Int J Environ Res Public Health 2023 January 18;20:1806. https://doi.org/10.3390/ijerph20031806, PubMed: 36767176, PubMed Central: PMC9914024. Wakui N, Matsuoka R, Togawa C, Ichikawa K, Kagi H, Watanabe M et al. Effectiveness of displaying traffic light food labels on the front of food packages in Japanese university students: a randomized controlled trial. Int J Environ Res Public Health 2023 January 18;20:1806. https://​doi.​org/​10.​3390/​ijerph20031806, PubMed: 36767176, PubMed Central: PMC9914024.
43.
go back to reference Nancy B, Leonor L, Jordi S. etiquetado nutricional; estudio cruzado Capacity analysis of health food choice by reference to consumers in two models of nutritional labeling; crossover study. Nutr Hosp. 2013 February;28:6254. 10.3305/nh. Análisis de la capacidad de elección de alimentos saludables por parte de los consumidores en referencia a dos modelos de. Nancy B, Leonor L, Jordi S. etiquetado nutricional; estudio cruzado Capacity analysis of health food choice by reference to consumers in two models of nutritional labeling; crossover study. Nutr Hosp. 2013 February;28:6254. 10.3305/nh. Análisis de la capacidad de elección de alimentos saludables por parte de los consumidores en referencia a dos modelos de.
46.
go back to reference Egnell M, Galan P, Fialon M, Touvier M, Péneau S, Kesse-Guyot E et al. The impact of the nutri-score front-of-pack nutrition label on purchasing intentions of unprocessed and processed foods: post-hoc analyses from three randomized controlled trials. Int J Behav Nutr Phys Act 2021 March 17;18:38. https://doi.org/10.1186/s12966-021-01108-9, PubMed: 33731145, PubMed Central: PMC7968175. Egnell M, Galan P, Fialon M, Touvier M, Péneau S, Kesse-Guyot E et al. The impact of the nutri-score front-of-pack nutrition label on purchasing intentions of unprocessed and processed foods: post-hoc analyses from three randomized controlled trials. Int J Behav Nutr Phys Act 2021 March 17;18:38. https://​doi.​org/​10.​1186/​s12966-021-01108-9, PubMed: 33731145, PubMed Central: PMC7968175.
48.
go back to reference van Kleef E, van Trijp H, Paeps F, Fernández-Celemín L. Consumer preferences for front-of-pack calories labelling. Public Health Nutr. 2008 February;11:203– 13. doi:10.1017/S1368980007000304. Epub 2007 Jul 2. PubMed: 17601362, PubMed Central: PMC2811400. van Kleef E, van Trijp H, Paeps F, Fernández-Celemín L. Consumer preferences for front-of-pack calories labelling. Public Health Nutr. 2008 February;11:203– 13. doi:10.1017/S1368980007000304. Epub 2007 Jul 2. PubMed: 17601362, PubMed Central: PMC2811400.
54.
go back to reference Julia C, Blanchet O, Méjean C, Péneau S, Ducrot P, Allès B, et al. Impact of the front-of-pack 5-colour nutrition label (5-CNL) on the nutritional quality of purchases: an experimental study. Int J Behav Nutr Phys Act. 2016 September;13:101. https://doi.org/10.1186/s12966-016-0416-4. Julia C, Blanchet O, Méjean C, Péneau S, Ducrot P, Allès B, et al. Impact of the front-of-pack 5-colour nutrition label (5-CNL) on the nutritional quality of purchases: an experimental study. Int J Behav Nutr Phys Act. 2016 September;13:101. https://​doi.​org/​10.​1186/​s12966-016-0416-4.
55.
go back to reference Vyth EL, Steenhuis IH, Vlot JA, Wulp A, Hogenes MG, Looije DH, et al. Actual use of a front-of-pack nutrition logo in the supermarket: consumers’ motives in food choice. Public Health Nutr. 2010 November;13:1882–9. https://doi.org/10.1017/S1368980010000637. Epub 2010 Apr 1. PubMed. Vyth EL, Steenhuis IH, Vlot JA, Wulp A, Hogenes MG, Looije DH, et al. Actual use of a front-of-pack nutrition logo in the supermarket: consumers’ motives in food choice. Public Health Nutr. 2010 November;13:1882–9. https://​doi.​org/​10.​1017/​S136898001000063​7. Epub 2010 Apr 1. PubMed.
Metadata
Title
Investigation of the 1-week effect of traffic light nutrition labeling on diet selection among Japanese university students: a randomized controlled trial
Authors
Nobuyuki Wakui
Raini Matsuoka
Kotoha Ichikawa
Chikako Togawa
Aika Okami
Shoko Kawakubo
Hinako Kagi
Mai Watanabe
Yuika Tsubota
Miho Yamamura
Yoshiaki Machida
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Nutrition
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-17815-4

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