The study aimed to evaluate the impact of different labels on consumers.

A new study in India has found that warning labels on food packets are most effective in helping consumers identify foods “high in sugar, saturated fat and sodium” as compared with other labelling formats.

Published in an open access journal Nutrients earlier this month, the study is the first peer-reviewed paper on the subject in an Indian context. It found that on most parameters, the Health Star Rating (HSR) format — where a product is assigned between half-a-star and five stars — was least effective.

FSSAI report

The study comes at a time the Food Safety and Standards Authority of India (FSSAI) is expected to issue its draft regulation on front-of-package labelling (FOPL) and has indicated that it favours HSR, inviting criticism from public health experts who have accused it of favouring the food industry.

The authors conducted an in-person randomised experiment on 2,869 adults in six States in India, where participants were shown food packets with one of five FOPLs — a control label (barcode), nutrient-specific warning label (octagon symbol indicating whether the product was high in salt/sugar or saturated fat), Health Star Rating, guideline for daily amount (GDA that gives nutritional content information) or traffic light label (indicating red, amber or green levels of nutrients of concern).

The objective of the study was to evaluate the impact of different labels in helping consumers correctly identify packaged products containing excess levels of nutrients of concern such as sugar, saturate fat and sodium.

The study found that relative to a control label, most number of participants were able to identify a nutrient of concern when they were presented a packet with a warning label with 60.8% recognising harmful nutrients as compared to 55% recognising them when they were shown a GDA label, and 54.8% when shown a traffic light label.

Health Star Rating label performed the worst with only 45% being able to recognise the three nutrients of concern.

Warning label outperformed other labels even where secondary outcomes were concerned such as perceived message effectiveness, which is predictive of behavioural change, argue the authors.

It also performed best on outcomes such as identifying products as unhealthy and making users concerned about health consequences.

The GDA and MTL performed best at grabbing attention. The HSR performed worse than all other FOPL types on most secondary outcomes.

Consumer awareness

However, the study also found that warning labels failed to statistically significantly reduce intentions to purchase unhealthy packaged products which is why the authors suggest “the need to reinforce any FOPL policy with a robust and focused communications campaign to increase consumer awareness and understanding.”

Of the participants, 50% were women with an educational level of 12 years or less. Their eligibility criteria for the study included being between the ages of 18 and 60 and being involved in decision making related to grocery purchases for their household at least half the time.

Suitable strategy

“In a country where there is a demographic transition taking place and there is dominance of non-communicable diseases and multiple morbidities such as diabetes, cardiovascular diseases, we need to adopt a suitable strategy based on evidence to make consumers aware of nutrients of concern. Our recommendation is for adopting warning labels,” Dr. S.K. Singh, Professor and Head, Department of Survey Research and Data Analytics, International Institute for Population Sciences, and the corresponding author, told The Hindu .

The FSSAI is expected to bring out draft regulations recommending Health Star Rating system based on a study commissioned by the food regulator and conducted by Indian Institute of Management, Ahmedabad (IIM-Ahmedabad), according to the minutes of a stakeholder’s meeting in February 2022.

This has led to global and Indian experts criticising the move and raising questions about the IIM-A study too, calling it scientifically wrong, alleging underlying bias as well as faulty interpretation as it too found warning labels more effective in reducing consumer intent to buy products with harmful nutrients yet recommended Health Star Rating.

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