Original ResearchInformation search behaviour, understanding and use of nutrition labeling by residents of Madrid, Spain
Introduction
Non-transmissible diseases related to diet, such as obesity, diabetes, cardiovascular diseases and cancer represent the number one worldwide cause of mortality and global burden of disease.1 The World Health Organization (WHO) adopted the ‘WHO Global Strategy on Diet, Physical Activity and Health’ to tackle non-transmissible diseases through the promotion of physical activity and healthy diet. This strategy recognized the importance of nutritional labeling as a key informational tool needed to facilitate the selection of healthy foods by consumers.2 The Spanish agency for food safety and nutrition (AESAN for its Spanish acronym) published the 2011 report ‘Minimum indicator set for the evaluation and follow-up of NAOS (Nutrition, Physical Activity, and Obesity Prevention Strategy’). The set of indicators include two on nutritional labeling: 1. percentage of consumers reporting using nutritional information in the selection of products to purchase, and 2. percentage of consumers reporting using nutritional information to plan their daily menus.3 This study analyzes these indicators in consumers of Madrid.
Nutrition labeling was voluntary in the European Union until the publication of the regulation (EU) 1169/2011, which made it a compulsory part of product labeling. In 2002, available nutrition information in packaged products across European countries varied widely between 30% in Greece and 80% in the United Kingdom.4 Between 2002 and 2010, however, nutrition labeling has become commonplace in Europe reaching an average of 85% of all products. This is in part due to the labeling requirement in products with nutrition and health claims.5 Spain reached 95% adherence, thus becoming one of the top countries in terms of nutrition labeling.6
Studies on consumers' understanding and use of packaged product labeling show a high interest for nutrition information while at the same time revealing a wide range in comprehension levels.7, 8, 9, 10, 11, 12, 13, 14, 15
Unfortunately, it is not clear how this information influences either purchasing decisions at the point of sale or dietary patterns.16 However, some studies suggest that individuals who read nutrition labels are more likely to report a diet characterized by a high consumption of fruits and vegetables and a low consumption of fats and foods with high cholesterol content.17, 18, 19, 20, 21 Many specific health issues would be better addressed by improved labels and more people reading and understanding them, such as cardiovascular health related to trans fatty-acids; obesity risk, type 2 diabetes related to sugar22, 23; hypertension related to sodium24: and risks for obesity, type 2 diabetes, dyslipidemia, hypertension, coronary disease, and colorectal cancer related to fiber.23 The few existing studies on this topic in Spain7, 8 are either based on small samples or are purely informative, qualitative in nature or with poor reporting on methods and results.7 This paper presents current quantitative information about the use of nutrition labeling in Madrid based in a relevant sample size, analysing potential associations between variables of interest (search behaviour, comprehension level, and use of nutrition information in food labels) and sociodemographic variables.
The goals of this study are to describe three key factors surrounding nutrition labeling: 1. Madrid residents' interest information search behaviour on food nutrition labeling; 2. Consumers' comprehension level of such information; and 3. Consumer's use of nutrition information to make purchasing decisions and plan their dietary menu.
Section snippets
Study design
This is a cross-sectional study of a sample of adults residing in Madrid, Spain. Data were collected between March and May of 2012 in five supermarkets of the main chains in the city who agreed to participate in the study. The sites were located in the following neighbourhoods: neighbourhood of El Pilar (Alcampo supermarket), Almenara (Dia supermarket), Moncloa (Eroski supermarket), and Mirasierra (Gama and Maxcoop supermarkets).
Data collection
A questionnaire based on instruments used in previous similar
Results
The response rate was 80.6% (299 participants out of the 371 consumers invited to participate). Of these, 121 were men (40.5%) and 178 were women (59.5%) with a mean age of 45.7 years (SD = 15.19, range = 19–91 years of age). The majority of questionnaires were filled out in two supermarkets, Alcampo (33.4%) and Eroski (29.8%). Most participants were citizens of Spain (84.8%), married or in a relationship (59.7%), living with one or two people (55.2%), with no dependent children under the age
Discussion
Over two thirds of consumers of the study read nutrition labels, occasionally or regularly, before a purchase. However, almost half of the consumers reported that they did not fully understand the nutrition information nor did they use it to plan their diet. The reasons reported most frequently for reading and not reading nutrition labels were: choosing healthier products (81.3%) and the lack of time (38.9%), respectively. Information on additives and fats drew the most interest among consumers
Acknowledgements
The authors like to thank the supermarket chains that participated by allowing the recruitment of consumers to the study. And also they like to thank the individuals who collaborated in the interviewing (Ligia Guerra, Concepción Sagarra, Carmen Figueroa, and Marcela Chahua) and in the data analyses (Javiera Valdés, Carmen Figueroa, and Javier Prado). They also thank Hosanna Soler-Vila, Ph.D. for her assistance in the translation of the original manuscript.
Ethical approval
Ethical approval was not required for
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