Warning labels for sugar-sweetened beverages and fruit juice: evaluation of 27 different labels on health effects, sugar content, energy and exercise equivalency

C Miller; K Ettridge; S Pettigrew; G Wittert; J Coveney; M Wakefield; D Roder; S Durkin; J Martin; E Kay; J Dono

doi:10.1016/j.puhe.2024.01.026

Warning labels for sugar-sweetened beverages and fruit juice: evaluation of 27 different labels on health effects, sugar content, energy and exercise equivalency

Public Health. 2024 May:230:138-148. doi: 10.1016/j.puhe.2024.01.026. Epub 2024 Mar 27.

Authors

C Miller¹, K Ettridge², S Pettigrew³, G Wittert⁴, J Coveney⁵, M Wakefield⁶, D Roder⁷, S Durkin⁶, J Martin⁸, E Kay⁹, J Dono²

Affiliations

¹ School of Public Health, The University of Adelaide, Adelaide, Australia; Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia. Electronic address: caroline.miller@adelaide.edu.au.
² Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia; School of Psychology, The University of Adelaide, Adelaide, Australia.
³ The George Institute for Global Health, University of New South Wales, Sydney, Australia.
⁴ Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and Faculty of Health Sciences, University of Adelaide, Adelaide, Australia.
⁵ College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
⁶ Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia; School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.
⁷ Cancer Epidemiology and Population Health, University of South Australia, Australia.
⁸ Food for Health Alliance, Cancer Council Victoria, Melbourne, Australia.
⁹ Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia; College of Education Psychology and Social Work, Flinders University, Adelaide, Australia.

PMID: 38547760
DOI: 10.1016/j.puhe.2024.01.026

Abstract

Objectives: Front-of-pack warning labels may reduce consumption of sugar-sweetened beverages, potentially mitigating negative health outcomes. Comparisons between different warning label types to inform future research and policy directions are lacking. This study compared 27 warning labels across six message types for their potential to reduce sugar-sweetened beverage consumption.

Design and methods: A national sample of regular soda (n = 2578) and juice (n = 1048) consumers aged 14-60 years participated in an online survey. Participants evaluated randomly allocated labels; one from each of six warning label sets (health-graphic, sugar-pictogram, sugar-text, exercise equivalents, health-text, energy information) on four measures of perceived effectiveness (PE: overall effectiveness, discourage from drinking, emotional response, persuasive potential). Participants could also provide open comments. A general linear model compared differences in mean scores across label sets for each measure of PE.

Results: PE ratings differed significantly between label sets. Labels clearly quantifying sugar content (sugar-teaspoons) received consistently high PE ratings, whereas 'high in sugar' labels did not. Health-graphic labels were rated highly across all PE measures except persuasive potential. Exercise labels only rated highly on persuasive potential. Health-text results were mixed, and energy labels were consistently low.

Conclusions: Simple, factual labels were easily interpreted and perceived as most effective. Labels quantifying sugar content were consistently high performers and should be advanced into policy to help decrease overconsumption of sugar-sweetened beverages.

Keywords: FOPL; Front-of-pack labels; Fruit juice; Population survey; Sugar-sweetened beverages; Sugary drinks; Warning labels.

MeSH terms

Beverages
Food Labeling / methods
Fruit and Vegetable Juices
Humans
Sugar-Sweetened Beverages*
Sugars

Substances

Sugars