BACKGROUND Obesity and chronic diseases could be prevented through improved diet. Most governments require at least one type of food labeling system on packaged foods to communicate nutrition information and promote healthy eating. This study evaluated adult consumer understanding and use of nutrition labeling systems in the US and Mexico, the most obese countries in the world. METHODS Adults from online consumer panels in the US (Whites n = 2959; Latinos n = 667) and in Mexico (n = 3533) were shown five food labeling systems: 1. Nutrition Facts Table (NFT) that shows nutrients of concern per serving; 2. Guideline Daily Amounts (GDA) that shows levels of nutrients of concern; 3. Multiple Traffic-Light (MTL) that color codes each GDA nutrient (green = healthy; yellow = moderately unhealthy; red = unhealthy); 4. Health Star Rating System (HSR) that rates foods on a single dimension of healthiness; 5. Warning Label (WL) with a stop sign for nutrients present in unhealthy levels. Participants rated each label on understanding ("easy"/"very easy to understand" vs "difficult"/"very difficult to understand"), and, for NFTs and GDAs, frequency of use ("sometimes"/"often" vs "never"). Mixed logistic models regressed understanding and frequency of use on indicators of labeling systems (NFT = ref), testing for interactions by ethnicity (US Latinos, US Whites, Mexicans), while controlling for sociodemographic and obesity-related factors. RESULTS Compared to the NFT, participants reported greater understanding of the WL (OR = 4.8; 95% CI = 4.4-5.3) and lower understanding of the HSR (OR = 0.34, 95% CI = 0.31-0.37) and the MTL (OR = 0.56, 95% CI = 0.52-0.61), with similar patterns across ethnic subgroups. Participants used GDAs less often than NFTs (OR = 0.48; 95%CI = 0.41-0.55), with the greatest difference among US Whites (OR = 0.10; 95%CI = 0.07-0.14). CONCLUSIONS Understanding and use of the GDA was similar to that of the NFT. Whites, Latinos, and Mexicans consistently reported the best understanding for WLs, a FOPL that highlights unhealthfulness of a product. Therefore, a FOPL summary indicator, such as WLs, may be more effective in both the US and Mexico for guiding consumers towards informed food choices.

中文翻译：

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美国白人和拉丁裔以及墨西哥人对食品标签系统的理解和使用：国际食品政策研究结果，2017 年。

背景技术肥胖和慢性疾病可以通过改善饮食来预防。大多数政府要求包装食品至少采用一种食品标签系统，以传达营养信息并促进健康饮食。这项研究评估了美国和墨西哥（世界上肥胖最严重的国家）成年消费者对营养标签系统的理解和使用情况。方法 向美国（白人 n = 2959；拉丁裔 n = 667）和墨西哥（n = 3533）在线消费者小组的成年人展示五种食品标签系统： 1. 营养成分表 (NFT)，显示每份食物中关注的营养素; 2. 每日指导摄入量 (GDA)，显示关注的营养素水平；3. 多重红绿灯 (MTL)，对每种 GDA 营养素进行颜色编码（绿色 = 健康；黄色 = 中度不健康；红色 = 不健康）；4. 健康星级评级系统（HSR），根据单一健康维度对食品进行评级；5. 警告标签 (WL)，带有停止标志，表示营养物质含量不健康。参与者对每个标签的理解程度进行评分（“容易”/“非常容易理解”与“困难”/“非常难以理解”），并且对于 NFT 和 GDA，使用频率（“有时”/“经常”与“绝不”）。混合逻辑模型回归对标签系统指标的理解和使用频率（NFT = ref），测试种族（美国拉丁裔、美国白人、墨西哥人）的相互作用，同时控制社会人口统计和肥胖相关因素。结果 与 NFT 相比，参与者对 WL（OR = 4.8；95% CI = 4.4-5.3）的了解更多，对 HSR（OR = 0.34，95% CI = 0.31-0.37）和 MTL（OR = 0.31-0.37）的了解较低。 = 0.56，95% CI = 0.52-0.61），不同种族亚组的模式相似。参与者使用 GDA 的频率低于 NFT（OR = 0.48；95%CI = 0.41-0.55），其中美国白人的差异最大（OR = 0.10；95%CI = 0.07-0.14）。结论 GDA 的理解和使用与 NFT 类似。白人、拉丁裔和墨西哥人一致表示对WL（一种强调产品不健康的FOPL）有最好的理解。因此，FOPL 摘要指标（例如 WL）在美国和墨西哥可能更有效地指导消费者做出明智的食品选择。