[Effects of front-of-package nutritional labeling of food and beverages: synopsis of systematic reviewsEfeitos da rotulagem nutricional frontal de alimentos e bebidas: sumário de estudos de revisão sistemática].

objectivesSynthesize available information on the effects of front-of-package nutritional labeling on choice, purchase, and consumption of food and beverages, and nutritional status of consumers, and identify factors that influence its effectiveness.

methodsA synopsis of systematic reviews was carried out following PRISMA recommendations. A literature search was performed in MEDLINE (PubMed), Cochrane Library, LILACS, EBSCOhost, and Scopus, limited to studies published in Spanish or English with no restrictions on date of publication. Methodological quality was evaluated using AMSTAR 2.

resultsSeven systematic reviews were included. Front-of-package labeling facilitated healthy food choices and had a variable effect on consumption and purchase dimensions. No systematic review evaluated effects on nutritional status. Cost and flavor, eating habits, educational level, and dominant information processing systems in the consumer influenced labeling effectiveness. Most of the systematic reviews showed methodological limitations and critically low confidence levels.

conclusionsFront-of-package labeling had a positive effect on healthy food choices, with variable results on purchase and consumption dimensions. Local studies with adequate methodological quality are needed to identify the most effective labeling format in each country. Implementation of labeling as public health policy should be accompanied by strategies to improve access to healthy foods, promote physical activity, and provide nutrition education to consumers.