Evidence map›Paper›PMID 39894077›Full record

SynthesisJournal of the Academy of Nutrition and Dietetics2025

The Relationship Between Fruit Drink Front-of-Package Claims, Fruit Imagery, and Ingredient Disclosures and Consumer Perceptions, Intentions, and Behavior: A Systematic Review.

Aviva A Musicus, Melissa L Jensen, Carol Mita, Diana R H Winters, Michael T Roberts, Sally Mancini, Jennifer L Harris, Frances Fleming-Milici, James W Krieger

Abstract readSystematic Review
In one paragraph

Synthesis in Journal of the Academy of Nutrition and Dietetics, 2025. 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
  2. Article
  3. 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

9 authors.

Aviva A MusicusHarvard T.H. Chan School of Public Health, Boston, Massachusetts; Center for Science in the Public Interest, Washington, District of Columbia. Electronic address: aam231@mail.harvard.edu.
Melissa L JensenSchool of Nutrition, University of Costa Rica, San José, Costa Rica.
Carol MitaFrancis A. Countway Library of Medicine, Harvard Medical School, Boston, Massachusetts.
Diana R H WintersResnick Center for Food Law and Policy, UCLA School of Law, Los Angeles, California.
Michael T RobertsResnick Center for Food Law and Policy, UCLA School of Law, Los Angeles, California.
Sally ManciniFood Research & Action Center, Washington, District of Columbia.
Jennifer L HarrisUConn Rudd Center for Food Policy and Health, Hartford, Connecticut.
Frances Fleming-MiliciUConn Rudd Center for Food Policy and Health, Hartford, Connecticut.
James W KriegerUniversity of Washington School of Public Health, Seattle, Washington; Healthy Food America, Seattle, Washington.

Funding

CVD Epidemiology Training Program in Behavior, the Environment and Global HealthT32HL098048 · NHLBI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Goodarz Danaei, ERIC B RIMM · 2009 to 2026
$6.9M
The Harvard Chan Education Program in Cancer Prevention and ControlT32CA057711 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Karen M. Emmons, ANNE LINDSAY FRAZIER · 2019 to 2026
$3.3M
NCI NIH HHS T32 CA057711NHLBI NIH HHS T32 HL098048
6 · The paper itself

Abstract

backgroundFruit drinks are the top source of added sugar in young children's diets, increasing their risk of chronic disease. It is unclear to what extent front-of-package marketing and disclosures influence parents' perceptions of fruit drinks and their intentions and decisions to purchase them. These data are needed to inform regulatory and legal action to reduce potentially misleading marketing and help parents make healthier choices for their children.

objectiveThis systematic review investigated the relationship between fruit drink front-of-package claims (nutrient, natural/implied-natural, or health-related), fruit imagery, and ingredient disclosures (sugar, nonnutritive sweeteners, and juice content) and consumer perceptions, intentions, and behavior.

methodsA comprehensive search was used to identify peer-reviewed, original quantitative, and/or qualitative research published any time using the following databases: PubMed, Embase, PsycInfo, CAB Abstracts, Web of Science Core Collection, and Business Source Complete. Searches were conducted during May 2022 and January 2023. Risk of bias was assessed using the Quality Assessment Tool for Quantitative Studies and the Critical Appraisal Skills Programme checklist for qualitative studies. Articles were grouped by exposure and narratively synthesized.

resultsSixteen articles met inclusion criteria. Reviewed studies found that natural claims-and, to some extent, nutrient claims and fruit imagery-are associated with increased selection, purchase intentions, perceived healthfulness, and appeal of fruit drinks; as well as increased misunderstandings of fruit drink juice content (overestimation) and added sugars content (underestimation). Ingredient disclosures-including percent-juice content and presence of added sweeteners-may help correct misperceptions about product healthfulness.

conclusionsFront-of-package claims and imagery can increase healthfulness misperceptions and selection of fruit drinks, and ingredient disclosures could partially correct those misperceptions. The US Food and Drug Administration should consider updating fruit drink front-of-package marketing regulations. More high-quality randomized experiments would be useful to inform federal and legal action to support parents in selecting healthier beverages for their children.

Indexed as

Consumer BehaviorFood LabelingFruitFruit and Vegetable JuicesChildChoice BehaviorFemaleFood PreferencesHumansIntentionMaleNutritive ValueParentsFood marketingFront-of-packageFruit drinksNutrient claimsSystematic review

Identifiers

PMID39894077
PMCPMC12740116

What OpenQuestion holds

Textmetadata
LicenceTDM
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.