Parents' subjective understanding, use, reasons for non-use and perceived effectiveness of food labelling formats in Germany: a cross-sectional study of the Nutri-score, nutrition information panel and ingredients list.

backgroundFood labels are intended to support healthier food choices, yet little is known about how parents engage with different labelling formats in Germany. This study examined parents' subjective understanding and use of three food labelling formats in Germany, the Nutri-Score, the Nutrition Information Panel (NIP) and the list of ingredients and identified factors associated with subjective understanding and use, reasons for non-use and perceptions of label effectiveness.

methodsCross-sectional data were obtained from an online survey of parents in Germany (n = 978). Participants were adults responsible for at least 50% of household food shopping, who lived with children under 18 years. Quota-based sampling approximated the distribution of parents by household income and municipality size. Descriptive analyses were used to summarize subjective understanding, use, reasons for non-use and evaluative aspects of the three food labelling formats. Multivariable logistic regression analyses were conducted to identify characteristics associated with subjective understanding and use, and generalized estimating equations were used to compare evaluative aspects across the three food labelling formats.

resultsMost parents reported subjective understanding of the Nutri-Score (84.8%), the NIP (83.7%) and the ingredients list (80.5%) and 73.7% reported subjective understanding of all three formats. Overall, 70.3% used the Nutri-Score, 74.2% the NIP and 70.6% the ingredients list, while 58.8% reported using all three. Stronger beliefs in the effectiveness of healthy eating were positively associated with subjective understanding and use, whereas higher perceived overload from nutrition information was negatively associated. Men were less likely than women to report subjective understanding or use of the NIP and the ingredients list. Lack of interest was the most frequently reported reason for non-use. More participants agreed that the Nutri-Score was easy to use, whereas more agreed they understood the information provided by the NIP.

conclusionA high proportion of German parents in this quota-based sample reported subjective understanding and use of multiple food labelling formats. Subjective understanding and use were consistently associated with beliefs about the effectiveness of healthy eating and perceived nutrition information overload. These findings may help inform future public health communication on food labelling. CLINICAL TRIAL NUMBER: Not applicable.