Nutrition Labeling Related Consumer Research at FDA

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Nutrition Labeling Related Consumer Researchat
FDA

• Chung-Tung Jordan Lin
• Center for Food Safety and Applied Nutrition
• U.S. Food and Drug Administration
• April 17-18, 2008
• Food Safety, Nutrition, and Health A
  Transatlantic Partnership
• Presidential Conference Center, Texas AM
  University
• The views expressed in this presentation are
  those of the author and
• do not necessarily represent the views of the
  U.S. FDA

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Outline

• FDA and Center for Food Safety and Applied
  Nutrition (CFSAN)
• Nutrition labeling as a public health
  intervention
• Consumer research at FDA/CFSAN
• Research observations related to nutrition
  labeling
• Summary and conclusions

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CFSAN/FDA Mission

• 25 cents of every dollar that US consumers spend
  are on products regulated by FDA 75 of the
  amount is on foods
• Mission of Center for Food Safety and Applied
  Nutrition -
• promoting and protecting the publics health by
  ensuring that the nations food supply is safe,
  sanitary, wholesome, and honestly labeled, and
  that cosmetic products are safe and properly
  labeled

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Public Health Interventions In Use or Mentioned

• Information (contents, access) affects
• food preferences
• food access and availability
• food nutritional attributes
• Education
• Food prices (taxes, subsidies), access,
  availability
• Environment
• Health care
• Individual costs (insurance, incentives)

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Nutrition Labeling
General principle truthful and not misleading
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Health Messages (often on the front panel)

• Health claim
• authorized claim
• SSA significant scientific
• agreement standard
• notification based on authoritative
• statement of a scientific body
• qualified health claim (a claim NOT
• meeting the SSA standard)
• Nutrient content claim
• the level of a nutrient in a food
• Structure/function claim
• how a nutrient affects or maintains normal
• body functions or structure
• Dietary guidance statement

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Other Health Messages (often on the front panel)
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Major FDA Initiatives Since the Nutrition
Labeling and Education Act of 1990

• 2002 Consumer Health Information for Better
  Nutrition Initiative
• qualified health claims
• dietary guidance statements
• 2003 Obesity Working Group
• prominence of calories
• serving size
• 2006 trans fat declaration, functional foods
• 2007 nutrient declaration, DV listing
• 2007 sodium, front-of-pack symbols

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What can Consumer Research Bring to Policy?

• CFSAN policies and educational activities protect
  and promote public health from consumption of
  regulated products
• Consumer communication an important tool to
  achieve the goal by providing information to aid
  informed decisions
• Consumer research helps enhance the design and
  effectiveness of policies and education
  activities by examining whether and how labeling
  and other information is read, understood and
  reacted by intended target audience, the consumer

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Types of Consumer Research at FDA

• Qualitative to explore and to confirm
• focus groups
• mental models
• Quantitative to establish causality,
  associations, prevalence
• experimental studies (Web, in-person)
• surveys (telephone, Web)

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How Labels May Help Promote the Public Health?
Consumers information, decision
aids, confidence, education
Nutrition labels
Better diet and health
Producers product attributes, availability
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Multiple Factors Associated with Obesity and
Overweight
Lifestyle behavior
genetics
Obesity and overweight
other (e.g., pathogens, image of overweight)
physical activity
at-home
away-from-home
diet
taste, habit
food labels (but absent for most items)
food labels
culture, tradition
taste, habit
nutrition profile
nutrition profiles
culture, tradition
costs
product availability
product availability
portion size
costs
food insufficiency
food insufficiency
other
other
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Nutrition Competes with Other Consumer Interests

• Taste / enjoyment (reward)
• Time / convenience
• Cost / value
• Habit / familiarity
• Brand
• Safety
• Environment
• Social status

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Food Labels Compete with Other Nutrition
Information

• Promotion, advertising
• Family, friends, acquaintance
• Cultural background
• Mass media
• Personal experience and self-diagnosis

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Nutrition Information Competes with Other
Information on the Label

• Principal Display Panel
• health/nutrition statements/graphics
• other quality claims/graphics
• process and environmental statements/graphics
• graphics, background
• Back Panel
• Nutrition Facts label between nutrients too
• list of ingredients
• graphics, background

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Observations about Food Label Use

• Want more information, but feel overwhelmed
• Often focus on a few nutrients ? fat and calories
• Health messages on the front capture attention
• as a short-cut
• not necessarily trusted, but deemed useful
• may cause erroneous perceptions or
  over-consumption
• disclosures or disclaimers not necessarily useful

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More Observations about Food Label Use

• Use of fat information is positively associated
  with
• confidence in using labels to choose a healthy
  diet
• perceived advantage of using labels rather than
  relying on own knowledge
• perceived time cost
• perceived importance of nutrition in food
  shopping
• perceived importance of a healthy/low fat diet
• general fat knowledge
• Use of fat information is negatively associated
  with calories from fat
• Other research suggests label use is related to
  healthier diet

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How Frequently did Consumers Read Food Labels at
First Purchase of a Product?
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How Labels were Used for Informational and
Planning Purposes?
To find out nutrient amounts
To get a general idea of a food
To plan meals
To decide how much to eat
of label readers who often used label
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How Labels Were Used for Product Selection and
Other Purposes?
To avoid certain ingredients
To verify advertising
To compare brands/foods
of label readers who often used label
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Most Consumers Have Heard of These Fats

who have heard of a fat
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More Know Sat Fat - Heart Risk Linkage Than Trans
or Omega 3 - Heart Risk Linkage
1
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Many Consumers Have Heard of These Fats
who have heard of a fat
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Many of Them, however, Cannot Tell the Links
Between These Fats and Risk of Heart Disease
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Likelihood That the Product Would Help Reduce
the Risk of a (Disease)
Very likely
Mean rating
Very unlikely
Type of claim
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Likelihood to Consider Buying the Product
Very likely
Mean rating
Very unlikely
Type of claim
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Summary and Conclusions

• Nutrition labeling can be a useful intervention
  to promote public health
• Yet, its effects are subject to competing forces
• Efforts to enhance the usefulness of nutrition
  labeling are a continuing process
• Consumer research provides valuable inputs

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Summary and Conclusions

• Ideas for future research
• subjective factors in label use and dietary
  behavior
• multi-disciplinary approach (e.g., behavioral
  economics)
• labeling of away-from-home foods
• longitudinal research tracking label use, diets,
  health outcomes and exploring causality
  relationships
• use of market data to investigate labeling
  effects on sales and product mixes
• meta-analysis of existing research