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Traffic light label may the best fit for front-of-pack labelling in China

Front-of-pack labels that utilize multiple traffic lights for specific nutrients are best understood and preferred by a wide variety of Chinese shoppers, according to a recent study.

The cross-sectional study of Chinese consumer preferences, published in the journal Nutrients, noted that poor diet is the biggest driver of non-communicable diseases (NCDs) globally, and causes 80% of deaths in China every year – adding that, according to a 2021 scientific research report on Chinese dietary guidelines, people in China consume excessive salt, edible oil, and added sugars.

“Pre-packaged food and processed food are important components of those unhealthy diets and account for a growing proportion,” said the authors, adding that China is now one of the world’s largest consumers of pre-packaged food.

Led by first author Jia Cui from the Chinese Academy of Medical Sciences, Beijing, the research team noted that to address this problem, many countries have introduced front-of-package labelling (FOPL), adding that the World Health Organisation (WHO) recommends FOPL to help parents make healthier food choices for their children.

“Furthermore, WHO recommendations for FOPL system development should consider the difference in country context. The New World Heart Federation (WHF) also stresses that consumer literacy rate and universal cultural norms on food and nutrients should be taken into account when implementing FOPL system,” said Cui and colleagues.

“But which type of FOPL resonates with parents in China?” they questioned. “There is an urgent need to identify a culturally and socioeconomically acceptable format of FOPL for Chinese consumers.”

Front-of-pack study preferences

The research team performed a cross-sectional study to investigate parental preferences for five widely used FOPL formats: multiple traffic lights (MTL); Nutri-Score; warning labels; endorsement logos (Health logos: Smart Choice); and a Guideline Daily Amount (GDA) system.

Cui and colleagues analysed findings from surveys from the parents of students in primary and secondary schools in six provinces and municipalities. Parents’ preferences were rated by multiple dimensions, including attraction, information provision, and helpfulness for making healthier choices.

Overall, multiple traffic lights was the preferred FOPL, with 35.1% of the respondents nominating it as attracting them most. This was followed by warning labels (21.9%), Smart Choice (16.6%), GDA (13.8%), and Nutri-Score (12.5%).

When asked which format provides the information they most needed, multiple traffic lights remained the preferred format (42.4%), followed by GDA (20.8%) and warning labels (19.3%). When asked about which FOPL provided helped them to select healthier food quickly, multiple traffic lights was still the preferred FOPL (33.5%), followed by warning labels (24.2%) and GDA (17.7%).

Parents want to see sugar, salt & fat content

Additionally, the survey found that parents thought the most needed nutrients to label were sugar, salt, and total fat, while the top three pre-packaged foods to label were ‘baked food’, ‘milk and dairy products’ and ‘sugar-sweetened beverages’.

Furthermore, the results found that parents’ perceptions were relatively consistent across sociodemographic sub-groups, with few differences observed by parents’ family roles, the number of children in the family, students’ grade and weight status.

“This study provides important knowledge about the preference for FOPL among parents from a representative population from six provinces in China,” said the authors.

“Such findings provide important implications for policy decision making,” they added, noting that the findings can help inform the planning and implementation of FOPL in China and help Chinese parents make healthier food choices.