Consumers perception, understanding and use of labelling information on food packaging, with particular reference to front-of-pack food labels. Clare Riches Assessment Number: Dissertation submitted in accordance with the requirements of the University of Chester for the degree of Master of Science Public Health Nutrition 13 th November 2008 Word Count: 16548
Acknowledgements I would like to thank Professor Cynthia Burek for her help and guidance in producing this project. I would also like to thank all those who took part in the study and extend particular thanks to Mary Devenport at Cheshire Women s Institute for her kind support. Finally, I would like to thank my friends, family and fellow students at the University of Chester for their support and encouragement throughout the time of this research, especially my sister, your brutal honesty and surprising generosity is always appreciated. I would like to dedicate this dissertation to Rosco as without his shoulder, ears and wonderful singing, it would not have been possible. 2
Abstract Background Evidence supporting the link between diet and health has prompted policy makers to develop nutrition related food labelling as an established communication medium of health messages. However, several studies have demonstrated the difficulty consumers face in understanding and using food labelling information. The recent introduction of Front Of Pack (FOP) labelling schemes, aim to aid consumers in making informed food choices. Whilst there has been substantial research on the perceived need of these systems, there is limited research on the impact they may be having to the consumer and how they may be affecting food choice. Purpose To develop an appreciation of consumers current attitudes to and understanding of food labelling, with particular reference to nutritional information. The study aims to assess if the Front of Pack voluntary nutritional labelling schemes are having an impact on consumer understanding of nutrition information and healthy food choice and if these labelling schemes are influencing food purchase decisions. Methods Participants were recruited from the general public. Four focus groups were conducted involving 22 people in total. Thematic analysis was used to analyse the data and build an understanding of consumer interest, perception knowledge and use of food labelling. Results Knowledge and understanding of food label varied across participant groups and within individuals. Use of FOP nutrition labels were used for one off meal purchases but rarely in the context of a whole diet. Consumers were generally confused and distrusting of the variety of different FOP nutrition labelling systems currently in use. Conclusions Individuals who have more of an interest in food labels and a belief in the ability of the information to aid food choice are more likely to use FOP labelling. FOP labelling improved general awareness of food and food choice, limited understanding shown of the relationship between food and health and the ability of FOP labelling to aid food choices that can be part of a healthy, balanced diet. 3
Declaration I hereby declare that work contained herewith is original and is entirely my own work (unless indicated otherwise). It has not been previously submitted in support of a Degree, qualification or other course. Name: Signed: Date: 4
Contents Page 1.0 Introduction 10 1.1 Overview 10 1.2 Aims 11 1.3 Research Questions 12 2.0 Literature Review 13 2.1 Health Strategy and Healthy Choices 13 2.2 Current Food Labelling Legislation 15 2.3 Labelling Behaviour 16 2.3.1 Consumer understanding and use of food labelling 16 2.3.2 Contribution of food labelling to a healthier diet 20 2.3.3 Are the formats making a difference to purchase choice? 20 2.4 Front Of Pack (FOP) Labelling 21 2.4.1 Background of FOP 21 2.4.2 Food information schemes 22 2.4.3 Present understanding of FOP 26 2.4.4 Effectiveness and use of FOP 27 2.5 Summary 32 2.6 Aims and Objectives 32 3.0 Methodology 34 3.1 Study Design 34 3.2 Sample Size 34 3.3 Population and Subjects 35 3.4 Procedures 37 3.5 Data Management and Analysis 38 3.6 Ethical Considerations 40 4.0 Results 41 4.1 Do consumers have an interest in food labelling? 41 4.2 Do consumers trust food labelling? 44 4.3 Do consumers value food labelling? 47 5
4.4 Do consumers understand food labelling? 49 4.5 Do consumers use food labelling? 53 5.0 Discussion 61 5.1 Do consumers have an interest in food labelling? 61 5.2 Do consumers trust food labelling? 63 5.3 Do consumers value food labelling? 65 5.4 Do consumers understand food labelling? 68 5.5 Do consumers use food labelling? 70 5.6 Limitations 72 5.7 Implications of the Research 73 6.0 Conclusions 75 6.1 Key Objectives 75 6.2 Research Questions 76 6.3 Significance for study 76 6.4 Implications for further study 77 7.0 References 78 Appendices Appendix A: Current EU labelling regulations and available voluntary 85 information on pre-packed foods. Appendix B: Summary of the key points from four systematic reviews on 86 labelling as cited by Murphy (2007). Appendix C: Advertisement Flyers for Recruitment 87 Appendix D: Letter of Approval to Approach Cheshire Women Institute 89 Appendix E: Recruitment Questionnaire 91 Appendix F: Participant Information Sheet 92 Appendix G: Consent Form 94 Appendix H: Discussion Guide 95 Appendix I: Sample photographs of the packaging used alongside the 97 discussion guide during the focus group sessions. Appendix J: Ethical Approval Confirmation Letter 103 Appendix K: Focus Group Transcripts 106 6
List of Figures Page Figure 1: Food Purchase Constraints and Operators, Garrett (2007) 19 Figure 2: Food Standards Agency Multiple Traffic Lights 22 Figure 3: Alternative Presentations of Multiple Traffic Lights 22 Figure 4: Guideline Daily Amount Presentation 23 Figure 5: Swedish Green Keyhole 23 Figure 6: Finnish Heart Symbol 24 Figure 7: Australia/New Zealand Pick the Tick 24 Figure 8: National Health Service/Food Standard Agency 5 a DAY 25 Figure 9: Alternative Presentation of 5 a DAY logo 25 Figure 10: Front Of Pack Calorie Flags 26 Figure 11: Further examples of Front Of Pack labelling logos 26 Figure 12: Key objectives and the themes that emerged from them 59 Figure 13: The importance attached to each key objective by each of the four 60 groups Figure 14: Consumer inferences on the search for and use of food labelling 62 information 7
List of Tables Page Table 1: Summary of key findings from literature reviewed on the 29 effectiveness and use of FOP labelling formats on food packaging, 2006 present. Table 2: Participants profile by group 37 Table 3: Limitations to the Study 72 8
Abbreviations DoH EC EEC EHN EU EUFIC FIS FOP FSA GDA HCHC HFTP IGD M&S MTL NDNS NFA NHF NHS TL WHO CWI Department of Health European Council European Economic Council European Heart Network European Union European Food Information Council Food Information Schemes Front of Pack Food Standards Agency Guideline Daily Amount House of Commons Health Committee Heart Foundation Tick Programme Institute of Grocery Distribution Marks and Spencer Multiple Traffic Light National Dietary Nutrition Survey National Food Association (Swedish) National Heart Foundation National Health Service Traffic Light World Health Organisation Cheshire Women s Institute 9