ARCHIVED - Research Synthesis on Nutrition Labelling
In Canada, laws governing the ingredient list and voluntary nutrition labelling systems on food packages date back to 1974 and 1988, respectively. Amendments to the Food and Drug Regulations were published in January 2003, requiring most pre-packaged foods to carry a Nutrition Facts table in a consistent format by December 2005. In addition, the regulations were updated for nutrient content claims, and diet-related health claims were allowed for the first time.
Health Canada's earliest effort in nutrition labelling education was a booklet developed for consumers in 1993. In 2003, Health Canada disseminated a Nutrition Labelling Toolkit for Educators to over 8,000 dietitians, after having recognized that a more comprehensive education initiative would be necessary to support the use of the food label. The Toolkit contained a Get the Facts booklet, ready-to-use presentations, posters and a tearsheet. Key messages coincided with the toolkit's release and served to create awareness of the new food label. Since then, Health Canada has continued to educate consumers and intermediaries on how to use the nutrition information on labels to make informed food choices. The Interactive Nutrition Label and Quiz (2006), the inclusion of the Nutrition Facts table in the revised Canada's Food Guide (2007), the Healthy Eating advertising campaign (2008) and updates to the Toolkit material (2008), as well as resources developed by stakeholders, such as Healthy Eating is in Store for You (2003), continued to raise awareness of the new food label. It is now recognized that to maximize the label's potential to assist Canadians in making informed food choices, efforts must shift to promoting nutrition label literacy.
Canadian Research on Use of the Food Label
To inform this synthesis, a review of Canadian studies conducted in the past five years that examined consumer use of nutrition labels was undertaken. The major studies reviewed were: Tracking Nutrition Trends, V, VI, and VII (National Institute of Nutrition and Canadian Food Information Council, 2004; Canadian Council of Food and Nutrition, 2006 and 2008); Qualitative Study on the Use and Understanding of Nutrition Labelling (NRG Research Group, 2007); Post-Campaign Evaluation - Healthy Eating (Environics Research Group, 2008); and Intermediaries' Use of Nutrition Labelling Resources and Future Needs (Ascentum, 2009). These studies demonstrate that, despite educational efforts by Health Canada and others, the understanding of nutrition labelling is not reaching its full potential to assist Canadians in making informed food choices.
Food Label Use
Food labels are viewed as an important source of nutrition information by about 70% of Canadian consumers. Consumers reported that the food label was their second most preferred vehicle to receive information, after the Internet, and the number one tool used by intermediaries to teach nutrition label reading to consumers. About 60% of consumers surveyed in 2008 reported always or usually reading the label on food products. Of these regular users, women, older Canadians, and those who claim to be knowledgeable about nutrition or have good eating habits tend to check the label more often. The Nutrition Facts table and the list of ingredients were the most consulted to help determine the nutrient and calorie content of a food.
Upwards of 80% of the general Canadian population has used the Nutrition Facts table to compare food products. However, Canadians are not using the % Daily Value to compare food products, but relying on other indicators, such as brand, price, nutrition claims, ingredient list and nutrient content. Furthermore, those who compare individual nutrients tend to use the absolute amount (mg, g) rather then the % Daily Value.
Although many Canadian consumers compare nutrition information on food products, it is estimated that only about 20% of Canadian consumers seek nutrition information when eating out. Results from U.S. and international consumer surveys indicate considerable consumer interest in having nutrition information available at food service establishments. Menus, brochures, menu boards and tray liners have been identified as the most useful means of presenting nutrition information in these establishments. It has been suggested that nutrition education, in conjunction with point-of-purchase information, may be necessary.
Obstacles to Using the Food Label
The review of the studies highlighted obstacles that consumers face when using the label. Canadians who have no or very little nutrition knowledge appear to have greater difficulty in finding information on the food label than those who are somewhat knowledgeable. Also, Canadians report varying levels of trust in the food labels. Although some consumers perceive the Nutrition Facts table and the list of ingredients as regulated, and therefore trustworthy, many others do not. Most consumers are unsure if the other elements of the food label are regulated.
The % Daily Value and the specific amount of food have been identified as both the most difficult concepts to teach to consumers, and the most misunderstood components of the Nutrition Facts table. Canadians are confused about how and for whom the % Daily Value is calculated, and those who feel they understand the concept are not totally confident in its use. Confusion related to the specific amount of food on the label arises when similar food products list different amounts of food. Consumers are concerned that the specific amount of food is not standard among similar food products.
Lack of knowledge of specific and individual requirements for calories and nutrients also poses a challenge. Although Canadians may use the Nutrition Facts table to assess the calorie and nutrient content of foods, they are unaware of the requirements for the nutrients listed in the Nutrition Facts table or of their own specific needs.
Other factors influence food choice and compete with the use of the Nutrition Facts table; taste, price, convenience, personal preference and habit may take higher priority than health when choosing foods.
Finally, consumers reported a lack of time and interest as reasons for not using the Nutrition Facts table when choosing foods and the perception that they already know which foods are healthful/unhealthful. Some consumers reported that the use of the Nutrition Facts table would only arise if they were actually afflicted with a disease as they do not see the value in using the Nutrition Facts table as a tool to prevent nutrition-related diseases.
Nutrition Labelling Education
Canadian consumers have highlighted areas of focus for nutrition labelling education that they feel would generate interest in using the Nutrition Facts table. These include: relating a health/nutrition benefit to the information found on the label; relating the information and the benefits to the individual and family health; improving nutrition knowledge; increasing awareness that nutrition labelling is regulated by Health Canada, and communicating why specific amounts of food may be inconsistent for some food products within a category.
Many means of reaching Canadians exist for nutrition labelling education and were reported by consumers and intermediaries: point-of-purchase, food packages, Internet and media were identified as the best means for consumer education. Internet/web site, on package/label and media were identified as current nutrition information sources and consumers' top three preferred methods to receive nutrition information.
What can be done?
As early as 1999, stakeholders recognized that Health Canada had the responsibility to educate Canadians about nutrition labelling and that there was a need for a multisectoral effort to ensure that the full potential of the food label is achieved.
The research studies have shown that Health Canada's audience for healthy eating messages should be further segmented based on their use of the Nutrition Facts table. Regular users, defined as those who report always, almost always or usually reading the Nutrition Facts table, would represent 63% of Canadians.
Findings from this research synthesis bring to light the following key issues that should be considered in a nutrition labelling education initiative:
- Difficulty in determining the amount of nutrients/amount of calories consumed when the amount of food eaten is different than the specific amount of food listed in the Nutrition Facts table;
- Poor understanding of the meaning of the % Daily Value and its use;
- Need for reference points to determine what is a little or a lot of a nutrient (% Daily Value);
- How to compare similar foods with different specific amounts of food;
- Low awareness that nutrition labelling is regulated by Health Canada (with the exception of the Nutrition Facts table);
- Poor motivation to use the label due to barriers such as time, effort and failure to recognize that the nutrition information on food labels can be used to prevent nutrition-related diseases;
- Insufficient knowledge of nutrient roles and functions to inform decision-making.
Messaging for regular users should communicate concepts in order to address the above-mentioned issues. Messages for non-users (37% of Canadians) should promote the fact that using the Nutrition Facts table is worth the effort and can help individuals select food as part of a healthy eating pattern.
Nutrition labelling education initiatives should be provided through a variety of channels, such as food packaging, point-of-purchase, mass media and the Internet.
Health Canada has been engaged in educating Canadians on nutrition labelling since 2003 and has raised awareness of the Nutrition Facts table. Research on the use of the information on food labels in Canada provides direction to increase consumers' self-efficacy in using the Nutrition Facts table to make informed food choices. Consumer challenges related to effective nutrition label use, confusion with the % Daily Value/specific amount of food and poor nutrition knowledge should be addressed. New messages to address these issues are required if the Nutrition Facts table is to reach its potential in assisting Canadians in making informed food choices.
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