Efficacy of "High in" Nutrient Specific Front of Package Labels-A Retail Experiment with Canadians of Varying Health Literacy Levels

Nutrients. 2020 Oct 20;12(10):3199. doi: 10.3390/nu12103199.


Background: In 2018, Health Canada, the Federal department responsible for public health, put forward a regulatory proposal to introduce regulations requiring a "High in" front-of-package label (FOPL) on foods that exceed predetermined thresholds for sodium, sugars, or saturated fat. This study evaluated the efficacy of the proposed FOPL as a quick and easy tool for making food choices that support reduction in the intakes of these nutrients.

Methods: Consumers (n = 625) of varying health literacy levels (HL) were assigned to control (current labeling with no FOPL) or one of four FOPL designs. They completed six shopping tasks, designed to control for internal motivations. Efficacy was measured with correct product selection and response time (seconds) to make food choices using repeated measures statistical modeling, adjusting for HL, task type, and task order. Eye-tracking and structured interviews were used to gather additional insights about participants' choices.

Results: Overall, FOPL was significantly more effective than current labeling at helping consumers of varying HL levels to identify foods high in nutrients of concern and make healthier food choices. All FOPL were equally effective.

Conclusions: "High in" FOPL can be effective at helping Canadians of varying HL levels make more informed food choices in relation to sugars, sodium, and saturated fat.

Keywords: food choices; front-of-package labels; health literacy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Canada
  • Choice Behavior
  • Consumer Behavior / statistics & numerical data
  • Dietary Fats*
  • Dietary Sugars*
  • Female
  • Food Labeling / legislation & jurisprudence
  • Food Labeling / methods*
  • Health Literacy / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Public Health / methods*
  • Recommended Dietary Allowances
  • Sodium, Dietary*
  • Young Adult


  • Dietary Fats
  • Dietary Sugars
  • Sodium, Dietary