Nutrition labels lead to healthier eating in teens, study finds

In a recently published study nutrientsResearchers at the Austin School of Public Health at the University of Texas Health Science Center (UTHealth) at Houston investigated how nutrition labels influence eating behaviors among middle and high school students in Texas.

Based on self-reported information, results suggest that improving nutrition literacy and using food labels can significantly improve diet quality for school-going adolescents.

Background

Nutrition labels can help people compare different food items and inform healthier decision-making. Food label use has increased significantly among American adults in recent years; Approximately 80% of adults make purchasing decisions based on label information. Using labels is associated with better nutritional quality and health outcomes.

Adolescent health is a policy priority because this period of life is critical to well-being in adulthood. Today, nearly one in four American adolescents is classified as obese, but studies on nutrition label use in this group reveal conflicting results.

Although one study found high levels of label use among adolescents, this did not translate into a healthier diet. Another found much lower levels of hashtag use. These conflicting results underscore a critical need for further research to understand how to best address and prevent adolescent obesity.

About the study

In this study, researchers used a cross-sectional design with data collected through the Physical Activity and Nutrition Survey from 2019 to 2020 in Texas. Throughout the academic year, students in eighth and eleventh grades completed survey questionnaires and answered questions about demographic information. knowledge, physical activity, nutrition, dental habits and screen time.

Their weight and height were also assessed to calculate body mass index (BMI). Students were also asked if they used food labels to inform their food choices. Participants were asked to respond on a five-point Likert scale ranging from ‘Always’ to ‘Never’. This was the primary predictor.

Students’ nutritional behavior was assessed using questions in which they reported how often they consumed various food items in the previous day. The list included 13 healthy foods, such as brown rice, vegetables, whole fruit and baked meats, and 13 unhealthy foods, such as flavored milk, fried meat, caffeinated drinks and frozen desserts. Food consumption surveys were administered Tuesday through Friday, including weekday consumption.

This information enabled the calculation of the healthy eating index (HEI) and the healthy foods index (HFI) from 0 to 100; where a higher score indicated a healthier diet. The primary outcomes of the study were HEI, HFI, and unhealthy foods index (UFI). Data were analyzed using adjusted and weighted linear and logistic regression models.

Results

The sample included 4,730 students, 49% of whom were female, more than half of whom were Hispanic, and whose average age was 14.7 years old. Most students were not economically advantaged, and almost 15% had limited English proficiency. Nearly 60% reported that they never or rarely use food labels when making eating decisions. Only 11% said they always trust labels when making food choices.

Regression analyzes showed that food label use was significantly positively associated with HEI and HFI scores and negatively associated with UFI scores. The researchers observed a dose-response relationship, with stronger relationships observed as the frequency of label use increased.

Individuals who constantly or almost always used food labels were more likely to eat healthy foods such as nuts, brown bread, cooked meats, fruits, and vegetables; They also reported consuming smaller amounts of chips, soda, and candy.

Results

Findings from this study clearly demonstrated a dose-response relationship. The benefits of using food labels were greater for those who used them more frequently, and students who always used food labels had significantly healthier diets than other groups. However, only 11% of students always used food labels; This shows that not many people use this resource.

Despite these benefits, many teens may have difficulty understanding complex nutritional information on labels. Using this information to guide food decision-making requires understanding and responding to information about which nutrients should be avoided or limited (sodium, added sugars, and saturated fats) and which nutrients are healthy (e.g., minerals and dietary fiber).

Strengths of this study included its state-level representative design; however, the study was also observational, which does not allow for causal inference, and relied on self-reported data, which is subject to recall and social desirability biases.

Future studies could investigate the mechanisms behind the observed relationships, how to promote food literacy and label use among youth, and investigate possible gender-based differences to meet the specific needs of male and female students.