A Brief Guide to Front-of-Pack Nutritional Labels


During the past 20 years, the global burden of chronic diseases such as obesity, high blood pressure, stroke, and diabetes has increased, causing millions of deaths per year (World Health Organization, 2020). One of the main factors associated with the development of these diseases is the high consumption of ultra-processed foods, which contain high levels of sugar, sodium/salt, as well as trans and saturated fats (Matos et al., 2021). Improvement in consumers' understanding of the nutritional value of foods is a key aspect in reducing the consumption of ultra-processed products. Thus, several public health organizations have proposed the development and implementation of Front-of-Pack (FoP) nutrition labeling systems to help consumers make informed and healthy food choices and to encourage producers to develop healthier products (European Commission, 2020; Packer et al., 2021).


FoP labels display information about the nutritional content of a product, making it easier for the consumer to understand the numeric information presented in the back-of-package (BOP) labels (World Health Organization, 2019). Although all FoP labels share the same regulatory objective – to allow consumers to identify products that contain an excessive amount of any nutrient - they have different ways of presenting the information. As a result, FoP labels are classified into two groups: nutrient specific labels and summary labels (European Comission, 2020; Temple, 2020).



Figure 2. Example of a Back-of-Package label

Figure 3. Example of a traffic light nutrient specific label

The nutrient specific labels include the so-called Guideline Daily Amount (GDA). The GDA illustrates the amount of nutrients a product contains per serving (in grams) and their contribution to an adult's recommended daily intake (Temple, 2020). A GDA label can be shown in black and white or in a ¨traffic light¨ format, in which the colors highlight the level of nutrient content: green for low-level, yellow for medium, and red for high-level (Temple, 2020; World Health Organization, 2019). The drawback of using this scheme is that consumers need to be trained to understand how to interpret the numeric information according to their needs. Furthermore, when using the color-coded version, consumers might be confused regarding the quality of the product when a product has two or more colors in the label (Tarabella & Voinea, 2013).


Figure 3. Example of a warning level system, used in countries such as Chile and Brazil
Figure 4. Example of nutrient color-coded label

Label category also includes nutritional warning labels, such as the black hexagon, which informs consumers when an excessive amount of one or more of the critical nutrients is present in the product, although it does not inform about other nutritional components (Song et al., 2021). The nutrient-specific color-coded labels are also considered part of this group. These labels use a combination of the traffic light system and textual information alerting to the content of critical nutrients in the product labels but do not include numbers in their labelling, just warnings (Song et al., 2021; World Health Organization, 2019).



Figure 4. The NutriScore label
Figure 5. The NutriScore label

The summary labels display the overall nutritional score of a product, using a summary value to give a final classification to the food (Temple, 2020). The most commonly used system is the NutriScore label, which rates a product from category A (dark green), which indicates high nutritional quality, to category E (dark orange), which indicates low nutritional quality (International Agency for Research on Cancer, 2021). To determine a score, this label system considers the energy, sugars, fat, fiber, protein, fruits, vegetables, legumes, and nuts contained within 100g of a product. The NutriScore label was invented in France and has been implemented as a nutritional guide for produce in several countries across Europe (Hercberg et al., 2021).


Another example of summary labels is the Health Star Rating system, which rates the nutritional profile of a product between 0.5 to 5 stars. The more stars a product has, the healthier it is. This system is used in Australia and New Zealand (Commonwealth of Australia, 2019). Although summary labels make it easier for consumers to identify healthy products and compare scores, they do not allow the consumer to identify whether a product contains excessive amounts of any critical nutrients (SINU Scientific Board & SINU Scientific Committee, 2021).


Figure 6. Example of a Health Star Rating (HSR)

Although FoPs have been proven to ameliorate consumers' abilities to identify healthy products (Egnell et al., 2018; Song et al., 2021; Temple, 2020) and have increased public interest in the content of food products (Bryła, 2020; Packer et al., 2021), there are still changes that need to be made. First, FoPs are not mandatory in most countries, and some sectors of the food industry are refusing to add these labels to their packaging, arguing that consumers are responsible for their own health and should be able to make their own choices, and that FoPs might not be an effective way to educate consumers (Global Health Advocacy Incubator, 2021).



Furthermore, there is an increasing need to unify the food labelling system. Using different labels could generate higher costs for the food industry and create confusion and a lack of trust among consumers (European Comission, 2020). Finally, it is necessary to develop more ways to reach and educate consumers on how to read FoP labels as a lack of knowledge or understanding defeats the purpose of nutritional front labeling (Ikonen et al., 2020).


Figure 7. Consumers are interested in the contents and value of the products.

Thus, Front-of-Pack nutritional labels are graphic tools aimed to help consumers make conscious choices regarding the nutritional value and health impacts of their food products. These labels come in different shapes and colors and display different information to alert the consumer. Each label has advantages and disadvantages to it and, for these reasons, should be regarded carefully when reading information on a package. Furthermore, there are still some challenges for the implementation of the labels around the world, and more effort is needed to engage the food industry and its consumers to advocate for food labelling.




Bibliographic references

Bryła, P. (2020). Who Reads Food Labels? Selected Predictors of Consumer Interest in Front-of-Package and Back-of-Package Labels during and after the Purchase. Nutrients, 12(9), 1–20. https://doi.org/10.3390/NU12092605


Commonwealth of Australia. (2019). Health Star Rating - About Health Star Ratings. Commonwealth of Australia. http://www.healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/About-health-stars


Egnell, M., Talati, Z., Hercberg, S., Pettigrew, S., & Julia, C. (2018). Objective Understanding of Front-of-Package Nutrition Labels: An International Comparative Experimental Study across 12 Countries. Nutrients, 10(10). https://doi.org/10.3390/NU10101542


European Comission. (2020). Report from the commission to the European Parlament and the council regarding the use of additional forms of expression and presentation of the nutrition declaration. https://ec.europa.eu/food/system/files/2020-05/labelling-nutrition_fop-report-2020-207_en.pdf


Global Health Advocacy Incubator. (2021). Front of Package Labeling-Industry Arguments Counter Messages and Evidence. https://advocacyincubator.org/wp-content/uploads/2021/08/Evidence_to_Support_FOPL.pdf


Hercberg, S., Touvier, M., & Salas-Salvado, J. (2021). The Nutri-Score nutrition label A public health tool based on rigorous scientific evidence aiming to improve the nutritional status of the population. International Journal for Vitamin and Nutrition Research. https://doi.org/10.1024/0300-9831/a000722


Ikonen, I., Sotgiu, F., Aydinli, A., & Verlegh, P. W. J. (2020). Consumer effects of front-of-package nutrition labeling: an interdisciplinary meta-analysis. Journal of the Academy of Marketing Science, 48(3), 360–383. https://doi.org/10.1007/S11747-019-00663-9/TABLES/6


International Agency for Research on Cancer. (2021). The Nutri-Score: A Science-Based Front-of-Pack Nutrition Label Helping consumers make healthier food choices. 1–2. https://www.iarc.who.int/wp-content/uploads/2021/09/IARC_Evidence_Summary_Brief_2.pdf


Khan, A. (2010). Chapter-18 Non-communicable diseases. In Mastering community medicine. essay, Jaypee Brothers Medical Pub.


Matos, R. A., Adams, M., & Sabaté, J. (2021). Review: The consumption of ultra-processed foods and non-communicable diseases in Latin America. Frontiers in Nutrition, 8. https://doi.org/10.3389/fnut.2021.622714


Packer, J., Russell, S. J., Ridout, D., Hope, S., Conolly, A., Jessop, C., Robinson, O. J., Stoffel, S. T., Viner, R. M., & Croker, H. (2021). Assessing the Effectiveness of Front of Pack Labels: Findings from an Online Randomised-Controlled Experiment in a Representative British Sample. Nutrients, 13(3), 1–15. https://doi.org/10.3390/NU13030900


SINU Scientific Board, & SINU Scientific Committee. (2021). “Front-of-pack” nutrition labeling. Nutrition, Metabolism and Cardiovascular Diseases, 31(11), 2989–2992. https://doi.org/10.1016/J.NUMECD.2021.07.021


Song, J., Brown, M. K., Tan, M., MacGregor, G. A., Webster, J., Campbell, N. R., Trieu, K., Ni Mhurchu, C., Cobb, L. K., & He, F. J. (2021). Impact of color-coded and warning nutrition labelling schemes: A systematic review and network meta-analysis. PLOS Medicine, 18(10). https://doi.org/10.1371/journal.pmed.1003765


Tarabella, A., & Voinea, L. (2013). Advantages and limitations of the front-of-package (FOP) labeling systems in guiding the consumers’ healthy food choice. Amfiteatru Economic, 15(33), 198–209. https://www.econstor.eu/handle/10419/168785


Temple, N. J. (2020). Front-of-package food labels: A narrative review. Appetite, 144, 104485. https://doi.org/10.1016/J.APPET.2019.104485


World Health Organization. (2019). Guiding principles and framework manual for front-of-pack labelling for promoting healthy diet. https://cdn.who.int/media/docs/default-source/healthy-diet/guidingprinciples-labelling-promoting-healthydiet.pdf?sfvrsn=65e3a8c1_7&download=true


World Health Organization. (2020). Non-communicable diseases fact sheet. World Health. https://doi.org/10.5005/jp/books/11410_18



Visual sources

Figure 1 (cover). Schrank, P. (2022). A European bunfight breaks out over food labels. [Illustration]. Retrieved from: https://www.economist.com/europe/2022/02/12/a-european-bunfight-breaks-out-over-food-labels


Figure 2. Waananen, L. (2019). What the FDA wants to change about the nutrition facts label. Inlander. [Illustration] Retrieved from:

https://www.inlander.com/Bloglander/archives/2014/03/01/what-the-fda-wants-to-change-about-the-nutrition-facts-label


Figure 3. Scott-Thomas, C. (2013). Combined traffic light and GDA labelling may improve teens’ food choices: Study [Illustration]. Retrieved from:

https://www.foodnavigator.com/Article/2013/06/17/Combined-traffic-light-and-GDA-labelling-may-improve-teens-food-choices-Study


Figure 4. Freire, W.B. (2016). A qualitative study of consumer perceptions and use of traffic light food labelling in Ecuador [Illustration]. Retrieved from: https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20170320115814173-0316:S1368980016002457:S1368980016002457_fig1g.jpeg


Figure 5. Ducrot, P. (2019). Nutri-Score: The story so far [Illustration]. Retrieved from:

https://eurohealthnet-magazine.eu/nutri-score-the-story-so-far/


Figure 6. Blakely, T. (n.d.). Health Star Rating (HSR) label impact on food formulation and consumer purchasing [Illustration]. Retrieved from:

https://mspgh.unimelb.edu.au/research-groups/centre-for-epidemiology-and-biostatistics-research/population-interventions/health-star-rating-hsr-label-impact-on-food-formulation-and-consumer-purchasing


Figure 7. Khosco J. (2018). You could stare at this incredibly detailed drawing of a grocery store for hours [Illustration]. Retrieved from: https://www.belfasttelegraph.co.uk/news/viral/you-could-stare-at-this-incredibly-detailed-drawing-of-a-grocery-store-for-hours-36933895.html


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Maria Alejandra Latorre Prieto

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