Evidence map›Paper›PMID 37328782›Full record

ArticleArchives of public health = Archives belges de sante publique2023

Efficacy of front-of-pack warning label system versus guideline for daily amount on healthfulness perception, purchase intention and objective understanding of nutrient content of food products in Guatemala: a cross-over cluster randomized controlled experiment.

María Fernanda Kroker-Lobos, Analí Morales-Juárez, Wilton Pérez, Tomo Kanda, Fabio S Gomes, Manuel Ramírez-Zea, Carolina Siu-Bermúdez

Abstract read
In one paragraph

Article in Archives of public health = Archives belges de sante publique, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Trial
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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

7 authors.

María Fernanda Kroker-LobosINCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Calzada Roosevelt 6-25 zona 11, Guatemala City, Guatemala. fkroker@incap.int.
Analí Morales-JuárezINCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Calzada Roosevelt 6-25 zona 11, Guatemala City, Guatemala.
Wilton PérezINCAP Unit Planning, Institute of Nutrition of Central America and Panama, Calzada Roosevelt 6-25 zona 11, Guatemala City, Guatemala.
Tomo KandaPan American Health Organization/World Health Organization, Diagonal 6 10-50 zona 10, Guatemala City, Guatemala.
Fabio S GomesPan American Health Organization/World Health Organization, 525 23rd St NW, 20037, Washington, DC, USA.
Manuel Ramírez-ZeaINCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Calzada Roosevelt 6-25 zona 11, Guatemala City, Guatemala.
Carolina Siu-BermúdezINCAP Unit Planning, Institute of Nutrition of Central America and Panama, Calzada Roosevelt 6-25 zona 11, Guatemala City, Guatemala. cluisas018@gmail.com.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundFront-of-package warning labels (FOPWL) have been adopted in many countries aiming at reducing the consumption of unhealthy food and drink products and have also been considered in Guatemala. The aim of the study is to evaluate the efficacy of FOPWL versus Guidelines for Daily Amount (GDA) on products' healthfulness perception (HP), purchase intention (PI) and the objective understanding of the nutrient content (UNC) in Guatemala.

methodsParticipants (children and adults) (n = 356) were randomly assigned to evaluate either FOPWL or GDA during a crossover cluster randomized experiment in rural and urban areas across 3 phases of exposure. During phase 1, participants evaluated mock-up images of single products (single task) and compared pairs of products within the same food category (comparison task) without any label. In phase 2, participants evaluated labels only (without any product), and during phase 3, they evaluated the same products and questions from phase 1, now depicting the assigned front-of-package label. We generated indicators for single-task questions and scores for comparison tasks, one for each HP, PI and UNC questions. We used intention-to-treat, difference-in-difference regression analysis to test whether exposure to FOPWL was associated with HP, PI and UNC, compared to GDA. We also tested models for children and adults and by area (rural/urban) separately adjusting for sociodemographic variables.

resultsIn single tasks, FOPWL significantly decreased the PI (β -18.1, 95%CI -23.3, -12.8; p < 0.001) and the HP (β -13.2, 95%CI -18.4, -7.9; p < 0.001) of unhealthy food products compared to GDA. In the comparison task, FOPWL significantly increased the UNC (β 20.4, 95%CI 17.0, 23.9; p < 0.001), improved PI towards healthier choices (OR 4.5, 95%CI 2.9, 7.0 p < 0.001) and HP (OR 5.6, 95%CI 2.8, 11.1; p < 0.001) compared to GDA. Similar results were found in children and adults and in urban and rural settings.

conclusionsFOPWL reduces products' healthfulness perception and purchase intention, and increases understanding of products' nutrient content compared to GDA.

Indexed as

Food labellingGDAGuatemalaWarning label system

Identifiers

PMID37328782
PMCPMC10273755

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LicenceCC BY
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Registered trials

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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.