Do sugar warning labels influence parents' selection of a labeled snack for their children? A randomized trial in a virtual convenience store

Lindsey Smith Taillie; Isabella C A Higgins; Allison J Lazard; Donna R Miles; Jonathan L Blitstein; Marissa G Hall

doi:10.1016/j.appet.2022.106059

Do sugar warning labels influence parents' selection of a labeled snack for their children? A randomized trial in a virtual convenience store

Appetite. 2022 Aug 1:175:106059. doi: 10.1016/j.appet.2022.106059. Epub 2022 May 5.

Authors

Lindsey Smith Taillie¹, Isabella C A Higgins², Allison J Lazard³, Donna R Miles⁴, Jonathan L Blitstein⁵, Marissa G Hall⁶

Affiliations

¹ Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, 135 Dauer Drive, 245 Rosenau Hall CB # 7461, Chapel Hill, NC, 27599, USA; Carolina Population Center, The University of North Carolina at Chapel Hill, 123 W Franklin Street, Suite 2107, Chapel Hill, NC, 27516, USA. Electronic address: taillie@unc.edu.
² Carolina Population Center, The University of North Carolina at Chapel Hill, 123 W Franklin Street, Suite 2107, Chapel Hill, NC, 27516, USA; Department of Health Behavior, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, 135 Dauer Drive, 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599, USA. Electronic address: ihiggins@email.unc.edu.
³ Hussman School of Journalism and Media, The University of North Carolina at Chapel Hill, Carroll Hall, CB 3365, Chapel Hill, NC, 27599, USA; Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC, 27514, USA. Electronic address: lazard@unc.edu.
⁴ Carolina Population Center, The University of North Carolina at Chapel Hill, 123 W Franklin Street, Suite 2107, Chapel Hill, NC, 27516, USA. Electronic address: drmiles@email.unc.edu.
⁵ Insight Policy Research, 1901 North Moore Street, Suite 1100, Arlington, VA, 22209, USA. Electronic address: jblitstein@insightpolicyresearch.com.
⁶ Carolina Population Center, The University of North Carolina at Chapel Hill, 123 W Franklin Street, Suite 2107, Chapel Hill, NC, 27516, USA; Department of Health Behavior, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, 135 Dauer Drive, 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599, USA; Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC, 27514, USA. Electronic address: mghall@unc.edu.

Abstract

Despite growing evidence that warning labels reduce purchases of sugary drinks, less is known about warnings' impact on purchases of sugary snacks. This paper aimed to experimentally test whether a front-of-package label warning about high sugar content ("sugar warning label") would reduce parents' likelihood of selecting a labeled snack versus a non-labeled snack for their child in a food store setting. Participants (n = 2,219 parents of at least one child aged 1-5y) were recruited via an online panel and asked to complete a shopping task in a virtual convenience store. Participants were randomized to one of three labeling conditions: barcode control, text-only sugar warning label, or pictorial sugar warning label. Participants viewed two granola snacks, one labeled and one unlabeled, and selected one for purchase. A post-shopping survey measured secondary outcomes. Predictions and analyses were preregistered on www.clinicaltrials.gov (NCT04381481). Participants exposed to the text or pictorial sugar warning labels were less likely to select the labeled snack than those in the barcode control group (21%, 18%, and 34% respectively; p < 0.001 for both comparisons of warning to control). Relative to the barcode control label, the text and pictorial sugar warning labels resulted in greater attention, anticipated social interactions, negative affect, cognitive elaboration, and perceived message effectiveness, as well as lower perceptions of healthfulness, appeal, and intentions to purchase or consume the product (p < 0.001 for all comparisons of warnings to control). There were no differences in outcomes between text and pictorial sugar warning labels. In conclusion, text and pictorial sugar warning labels reduced parents' likelihood of selecting a labeled granola snack for their children. These results contribute to a growing body of evidence showing that warning labels influence food purchasing behaviors.

Keywords: Added sugar; Childhood obesity; Food policy; Front-of-package labels; Marketing; Randomized controlled trial.

Associated data

ClinicalTrials.gov/NCT04381481

Abstract

Associated data

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