Consumer Perception of the Healthfulness of Ultra-processed Products Featuring Different Front-of-Pack Nutrition Labeling Schemes

Objective: To examine the influence of front-of-pack nutrition information on the perception of healthfulness of ultra-processed products across 2 income levels. Design: A between-participants design was used to compare healthfulness perception of ultra-processed products featuring different front-of-pack nutrition information schemes (guideline daily amount system, traffic light system, and monochromatic traffic light system). Participants: A total of 300 people (aged 18-70 years, 75% female) from Montevideo, Uruguay, participated in the study; half were middle-or high-income people and the other half were low-income people. Main Outcome Measures: Participants were shown the labels of each product and asked to rate their perceived healthfulness and the frequency with which each product should be consumed. Analysis: Results were analyzed using analysis of variance for statistical significance (P < .05). Results: Low-income participants perceived ultra-processed products to be significantly (P < .05) more healthful than did middle-and high-income participants. The lowest perceived healthfulness scores for low-income participants were obtained for products featuring the colored and monochromatic traffic light system whereas no significant differences (P > .05) among schemes were found for middle -and high-income participants. Conclusions and Implications: Nutrition education programs aimed at increasing low-income people's knowledge of the nutritional composition of these products and their potential negative effects on health seem to be necessary. Although the inclusion of semidirective front-of-pack nutrition information decreased the perceived healthfulness of low-income people, it seemed unlikely to influence how they perceive these products.