Nutrition labels: Attention to, understanding and use in food choice by people referring to health houses in Tehran, Iran
Objective: Nutrition labels can be used as a guide for choosing healthier foods and adopting a better diet. The aim of this study was to determine users’ attention to, understanding, and, use of nutrition labels and their relationship with sociodemographic characteristics and anthropometric status.
Methods: This cross-sectional study was conducted from spring to summer 2017. Using random cluster sampling, a total of 384 adults were selected from among the people referring to health houses in Tehran. Data were collected using a researcher-designed questionnaire completed by interviewing the subjects and analyzed through stepwise multiple regression analysis.
Results: Women were more prone to pay attention to nutrition labels (P=0.05). People with academic education understood nutrition labels (about 7 times) more than other people (P=0.02). Furthermore, the participants’ understanding of nutrition labels decreased with aging (P< 0.001). People with a higher economic level and a recent history of going on a specific diet used nutrition labels more than other people (P< 0.001). In addition, people with a history of diabetes mellitus were more likely to pay attention to nutrition labels (P=0.03) and use in food choice (almost 8 times more than healthy subjects) (P=0.04).
Conclusions: Attention to, understanding and use of nutrition labels by the subjects were strongly associated with age, economic status, educational level and recent history of going on a particular diet. Individuals with a normal body weight paid more attention to and were willing to use the information contained in food labels.
2. World Health Organization. Global strategy on diet, physical activity and health. 2004.
3. Alimentarius C. Guidelines on nutrition labelling CAC/GL 2-1985 as last amended 2010. Jt FAO/WHO Food Stand Program Secr Codex Aliment Comm FAO, Rome. 2010;
4. Food Drug Administration. Guidance for industry: a food labeling guide (14. Appendix F: calculate the percent daily value for the appropriate nutrients). URL (http//www fda gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm064928 htm)(2608 16) There is no Corresp Rec this Ref. 2016;
5. Food Drug Administration. Food Drug Administration Administrative instructions: criterias about food and beverage labeling [Internet]. Vol. 2017. 2014 [cited 2018 Oct 25]. Available from: http://www.fda.gov.ir/item/2108
6. Campos S, Doxey J, Hammond D. Nutrition labels on pre-packaged foods: a systematic review. Public Health Nutr. 2011;14(8):1496–506.
7. Satia JA, Galanko JA, Neuhouser ML. Food nutrition label use is associated with demographic, behavioral, and psychosocial factors and dietary intake among African Americans in North Carolina. J Am Diet Assoc. 2005;105(3):392–402.
8. Prieto-Castillo L, Royo-Bordonada MA, Moya-Geromini A. Information search behaviour, understanding and use of nutrition labeling by residents of Madrid, Spain. Public Health. 2015;129(3):226–36.
9. Kim M-G, Oh S-W, Han N-R, Song D-J, Um J-Y, Bae S-H, et al. Association between nutrition label reading and nutrient intake in Korean adults: Korea National Health and Nutritional Examination Survey, 2007-2009 (KNHANES IV). Korean J Fam Med. 2014;35(4):190–8.
10. World Health Organization. Obesity: preventing and managing the global epidemic. World Health Organization; 2000.
11. Cecchini M, Warin L. Impact of food labelling systems on food choices and eating behaviours: a systematic review and meta‐analysis of randomized studies. Obes Rev. 2016;17(3):201–10.
12. Nielsen. A Nielsen Report Battle of the Bulge & Nutrition Labels Healthy Eating Trends Around the World [Internet]. 2012. Available from: http://silvergroup.asia/wp-content/uploads/2012/02/Nielsen-Global-Food-Labeling-Report-Jan2012.pdf
13. Besler HT, Buyuktuncer Z, Uyar MF. Consumer understanding and use of food and nutrition labeling in Turkey. J Nutr Educ Behav. 2012;44(6):584–91.
14. Bleich SN, Wolfson JA. Differences in consumer use of food labels by weight loss strategies and demographic characteristics. BMC Public Health. 2015;15(1):1.
15. Drichoutis AC, Lazaridis P, Nayga Jr RM. Consumers’ use of nutritional labels: a review of research studies and issues. Acad Mark Sci Rev. 2006;2006:1.
16. Grunert KG, Wills JM. A review of European research on consumer response to nutrition information on food labels. J Public Health (Bangkok). 2007;15(5):385–99.
17. Azman N, Sahak SZ. Nutritional label and consumer buying decision: a preliminary review. Procedia-Social Behav Sci. 2014;130:490–8.
18. Laz TH, Rahman M, Berenson AB. Association of frequent use of food labels with weight loss behaviors among low-income reproductive-age women. J Am Coll Nutr. 2015;34(1):73–9.
19. Chopera P, Chagwena DT, Mushonga NGT. Food label reading and understanding in parts of rural and urban Zimbabwe. Afr Health Sci. 2014;14(3):576–84.
20. Cowburn G, Stockley L. Consumer understanding and use of nutrition labelling: a systematic review. Public Health Nutr. 2005;8(01):21–8.
21. Hassan HF, Dimassi H. Usage and understanding of food labels among Lebanese shoppers. Int J Consum Stud. 2017;41(5):570–5.
22. Post RE, Mainous AG, Diaz VA, Matheson EM, Everett CJ. Use of the nutrition facts label in chronic disease management: results from the National Health and Nutrition Examination Survey. J Am Diet Assoc. 2010;110(4):628–32.
23. Lewis JE, Arheart KL, LeBlanc WG, Fleming LE, Lee DJ, Davila EP, et al. Food label use and awareness of nutritional information and recommendations among persons with chronic disease. Am J Clin Nutr. 2009;90(5):1351–7.
24. Vioque J, Weinbrenner T, Castelló A, Asensio L, Hera MG. Intake of fruits and vegetables in relation to 10‐year weight gain among Spanish adults. Obesity. 2008;16(3):664–70.
25. Nianogo RA, Kuo T, Smith L V, Arah OA. Associations between self-perception of weight, food choice intentions, and consumer response to calorie information: a retrospective investigation of public health center clients in Los Angeles County before the implementation of menu-labeling regulation. BMC Public Health. 2016;16(1):60.
26. Misra R. Knowledge, attitudes, and label use among college students. J Am Diet Assoc. 2007;107(12):2130–4.