Evidence map›Paper›PMID 35864545›Full record

Trial reportNutrition journal2022

Objective understanding of front of pack warning labels among Mexican children of public elementary schools. A randomized experiment.

Alejandra Contreras-Manzano, Alejandra Jáuregui, Jorge Vargas-Meza, Claudia Nieto, Adriana Granich-Armenta, María de Lourdes Alemán Escobar, Armando G-Olvera, Carlos Cruz-Casarrubias, Ana Munguía, Simón Barquera

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Nutrition journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
4.8field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Alejandra Contreras-ManzanoCenter for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico.
Alejandra JáureguiCenter for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico. alejandra.jauregui@insp.mx.ORCID 0000-0001-9158-2007
Jorge Vargas-MezaCenter for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico.
Claudia NietoCenter for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico.
Adriana Granich-ArmentaCenter for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico.
María de Lourdes Alemán EscobarCenter for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico.
Armando G-OlveraCenter for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico.
Carlos Cruz-CasarrubiasCenter for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico.
Ana MunguíaCenter for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico.
Simón BarqueraCenter for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico.
Instituto Nacional de Salud Pública · MXNational Institute of Public Health · SI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWarning Labels (WL) highlight excessive amounts of critical nutrients in order to discourage consumption of unhealthful packaged food products. This study aimed to evaluate among Mexican school children, the objective understanding of traditional and numeric WL (aimed at small products) considered by the Mexican regulation, and whether cartoon characters influenced the understanding of WL. We also tested some communication strategies to facilitate the correct use of the WL.

methodsWe carried out a randomized experiment in July 2019 in public elementary schools from Morelos, Mexico. Participants aged 6-13 years, were randomly assigned to one of four groups: 1) Nutrient Facts Panel (NF) (n = 120), 2) Nutrient Facts Panel with cartoon characters (NF + C) (n = 83), considered the control groups, 3) Warning Labels (WL) (n = 109), and 4) Warning Labels with cartoon characters (WL + C) (n = 96). After allocation, children assigned to both WL groups (WL or WL + C), were randomly required to watch two posters simultaneously or a video explaining how to correctly interpret WLs. Logistic regression models adjusted by sex, age and cluster (school) were fitted.

resultsThe percentage of children correctly choosing the healthiest or the unhealthiest option was higher for WL groups (56.8, 95%CI; 40.8-72.8) compared to NF groups (24.3, 95%CI; 20.4-28.3, p < 0.05). The understanding of traditional WL was higher (28.7, 95%CI: 22.8-35.4) than the numeric WL (19, 95%CI: 14.2-25.0, p < 0.05). But, correct answers for identifying healthy and unhealthy products were higher for numeric WL than for NF groups. Cartoon characters reduced the percentage of correct answers for choosing unhealthiest products (WL + C: 48.9, 95%CI: 25.6-72.4 vs WL: 58.7, 95%CI: 36.4-81.1, p < 0.05). The video was 2.23 times more helpful than the posters to the correct interpretation of the WL (p < 0.05).

conclusionsIn scholar Mexican children, traditional and numeric WL were useful to identify healthier and unhealthier packaged products in comparison to NF, suggesting that both WL formats may effectively communicate the excessive content of nutrients of concern among children. Cartoon characters may reduce the objective understanding of the WL, underscoring the need to regulate advertising directed to children along with the implementation of front-of-pack labeling.

Indexed as

Consumer BehaviorFood LabelingAdvertisingChildFood PreferencesHumansMexicoNutritive ValueCartoon charactersChildrenFront-of the-pack labelingMarketingNutrition factsObjective understandingWarning labels

Identifiers

PMID35864545
PMCPMC9306177
OpenAlexW4286433148

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.