Front of Pack Nutritional Labeling of Processed Foods Among Mexican Consumers
NCT ID: NCT04308408
Last Updated: 2020-03-17
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
2105 participants
INTERVENTIONAL
2018-05-01
2018-06-30
Brief Summary
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Detailed Description
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In general, for nutrition labels to have any effect on purchasing decisions, consumers must first be exposed to them and perceive the displayed information on the labels. Then, the effect will be mediated by consumer understanding. Based on this understanding, consumers may use the label to make inferences about the nutritional quality or healthiness of the product, which, together with other information (e.g. trust or liking of the label or taste of the product) may affect the evaluation of the product and eventually the purchase decision of the product.
GDA provide numeric information on the content of key nutrients in the food product without interpreting the information.
MTL and WL are nutrient-specific labels providing an interpretation of the nutritional content of specific nutrients in the product. The MTL uses traffic light colors to indicate the high (red) or low (green) content of key nutrients, whereas the WL are only included in a product when the content of each key ingredient is above specific criteria.
Trained undergraduate student research assistants from eight universities across the country recruited the study participants. Research assistants were trained on how to approach and recruit participants and obtain informed consent. They were instructed to recruit 20 or more participants each. Recruitment took place in public spaces previously selected by convenience by the research team, based on their use by low- and middle-income groups in Mexico (i.e., public schools, public squares, public health centers, as well as supermarket chains and shopping centers located in low-income neighborhoods). Potential participants were approached by research assistants, who explained study objectives and invited them to be part of the study. Then, individuals were screened for eligibility using a 3-item screener. To access this screener, research assistants used a tablet or laptop with internet-access, to access a unique web address where our web-based tool was hosted. Research assistants were automatically informed by the web-based tool about the eligibility of the participant. Informed consent was obtained from all eligible participants using an automated computer-based form. Then, the tablet or laptop was handed to participants, who completed a self-administered online demographic and health survey, and then accessed the online shopping site to simulate a shopping situation. Participants completed the shopping task on the same day at the public place where they were recruited.
After allocation, participants viewed a video explaining how to correctly interpret the assigned label. Each participant was asked to shop freely, to better mimic real-world grocery shopping conditions. Research assistants instructed participants as follows: "take into account the assigned label and choose your preferred products". Participants were assigned an initial budget to do their shopping, although they did not pay actual money for their groceries. This budget corresponded to their weekly expenditure in groceries reported in the demographic survey, from 500-5000 Mexican pesos ($28-280 USD), in multiples of 500. No specific instructions were given related to the number or total cost of food products purchased.
FOP nutrition labels were affixed on the food items of the virtual supermarket. The store displayed the name, price and the front of the pack image of 60 food products from 5 food groups (ready-made foods, dairy products, non-dairy beverages, salty snacks, and breakfast cereals). Products were shown on traditional shopping shelves. Participants could zoom in to look more closely at the products and their prices, and could click on the product to access a new pop-up window. This new window displayed product information (i.e., name and brand), a larger image of the front of the product packaging, and an area where they could select the amount or number of products they wanted to put in their shopping cart. The pop-up window was the only way in which participants could select the food products to "purchase". Participants could also zoom in further on this pop-up to look more closely at the package and the nutritional label.
After completing their shopping, participants revised their shopping cart and "purchased" their products. A brief feedback on the nutritional quality of the products in their shopping cart was provided as a retribution for their time.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
DOUBLE
Study Groups
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Mexican Guideline Daily Allowance (GDA)
Guideline Daily Amounts (GDA) is a purely numerical and reductive labeling system, indicates the grams and percentages (according to the guideline-based daily intakes) per portion of kilocalories, saturated fats, other fats, sugars, and sodium, with no specific judgement, opinion or recommendation.
Guideline Daily Amounts
All food items displayed the corresponding GDA label in the lower left corner of the front of the package.
Video
Participants viewed a short (less than 1 min) video explaining how to interpret the label.
Ecuador's Multiple Traffic Light (MTL)
Multiple traffic light labels, an interpretive nutrient-specific FOP label, use the typical traffic light colors (green, yellow/amber, red) and text descriptors to indicate the high, medium, or low content of total fat, sugar and salt.
Multiple Traffic Light
All food items displayed the corresponding MTL label in the lower left corner of the front of the package.
Video
Participants viewed a short (less than 1 min) video explaining how to interpret the label.
Chilean Warning Labels in Red
Warning Labels (WL), another nutrient-specific interpretive FOP labelling scheme, include 'high in' symbols for products that exceed limits of energy, sodium, sugar and saturated fat.
Warning Labels
Food products were labeled with "High in" labels In the lower left corner of the front of the package. In total, 37 of the 60 food products in the shopping site did not display a WL.
Video
Participants viewed a short (less than 1 min) video explaining how to interpret the label.
Interventions
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Guideline Daily Amounts
All food items displayed the corresponding GDA label in the lower left corner of the front of the package.
Multiple Traffic Light
All food items displayed the corresponding MTL label in the lower left corner of the front of the package.
Warning Labels
Food products were labeled with "High in" labels In the lower left corner of the front of the package. In total, 37 of the 60 food products in the shopping site did not display a WL.
Video
Participants viewed a short (less than 1 min) video explaining how to interpret the label.
Eligibility Criteria
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Inclusion Criteria
* Shopping for groceries at least twice per week
Exclusion Criteria
* Having any of their direct family members working in the food and beverage industry
18 Years
ALL
Yes
Sponsors
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Instituto Nacional de Salud Publica, Mexico
OTHER
Responsible Party
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Alejandra Jáuregui de la Mota
Chair of the Department of Physical Activity and Healthy Lifestyles
Principal Investigators
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Alejandra Jauregui, ScD
Role: PRINCIPAL_INVESTIGATOR
Instituto Nacional de Salud Pública
Locations
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Hospital de Alta Especialidad del Bajío
León, Guanajuato, Mexico
Universidad Autónoma Metropolitana
Mexico City, Mexico City, Mexico
Univesidad Autónoma de Morelos
Cuernavaca, Morelos, Mexico
Universidad Autónoma de Nuevo León
Monterrey, Nuevo León, Mexico
Universidad de Monterrey
Monterrey, Nuevo León, Mexico
Universidad Iberoamericana
Mexico City, , Mexico
Universidad Nacional Autónoma de México
Mexico City, , Mexico
Universidad Autónoma de San Luis Potosí
San Luis Potosí City, , Mexico
Countries
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References
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Jauregui A, Vargas-Meza J, Nieto C, Contreras-Manzano A, Alejandro NZ, Tolentino-Mayo L, Hall MG, Barquera S. Impact of front-of-pack nutrition labels on consumer purchasing intentions: a randomized experiment in low- and middle-income Mexican adults. BMC Public Health. 2020 Apr 6;20(1):463. doi: 10.1186/s12889-020-08549-0.
Provided Documents
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Document Type: Study Protocol and Statistical Analysis Plan
Other Identifiers
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7-68S4-17
Identifier Type: -
Identifier Source: org_study_id
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