UNDERSTANDING the factors which affect food choice are important as governments grapple with rising levels of overweight and obesity and search for effective ways to get consumers to change their behaviour and choose healthier diets.
One part of the healthier eating equation is the provision of nutrition information on foods and beverages that allow consumers to make informed choices.
But just how do consumers use this information and what is their level of understanding? A review of studies on nutrition labelling by Grunert and Wills (2007) found that while most consumers say that they use food labels, actual usage in a shopping setting may be far lower than self-reported figures.
Most of the studies on food labelling to date have been undertaken in the US and the UK. These markets are very different to the Asian environment so the results may or may not be relevant to this part of the world.
The Asian way
To gain a better understanding of how consumers in Asia choose foods and the ways in which they use nutrition information on food labels, the Asian Food Information Council (AFIC) undertook research in China and Thailand in October/November 2007. The respondents (about 400 in each market) were aged 13 to 49 years of age and were the main grocery decision makers in their family or social unit. Non-grocery shoppers were also surveyed to see if there were any differences in their attitudes.
The main finding was that people choose foods and beverages based on a number of factors. In Shanghai, grocery shoppers ranked high nutrient content, freshness and taste the top three factors in their decision making. The findings in Thailand were similar with freshness, value for money (meaning the food was affordable and filling/satiating), high nutrient content and taste being the most important factors in food choice.
Non-grocery shoppers ranked freshness as the most important attribute in food choice in both Shanghai and Bangkok.
These findings are not really surprising. Most other studies, including those in the US and European countries, have shown that taste and value for money are more important than nutrition in everyday food choice.
In Asian countries other factors also come into play when looking at the relative effectiveness of food labels in affecting food choice. For example, many meals are eaten outside of the home and these foods do not generally carry any nutrition information, yet they constitute a significant proportion of daily calorie intake.
More than half the respondents in the AFIC study in Bangkok said they ate out at least once a day, mostly at hawker centres. In Shanghai, the incidence of eating out was about once a week.
It is also common practice for people in Asian countries to shop at wet markets for foods and beverages. In Bangkok for example, 97% of grocery expenditure is at wet markets where foods are not pre-packaged and shoppers have little if any information on their nutritional value.
Do shoppers use nutrition information on labels?
Despite the fact that many of the more commonly eaten foods in Bangkok and Shanghai are unlabelled, most shoppers seem to be aware of nutrition labels on packaged foods and drinks.
Grocery shoppers in Bangkok were much more likely to claim to use nutrition information on food labels than those in Shanghai, with three in four shoppers in Bangkok saying they use the information and about half of the shoppers using it in Shanghai.
The information most commonly searched for on labels was the content of food additives and the fat levels as well as information on protein, sugars, vitamin and minerals and calories.
The fact that shoppers claim to use food labels is encouraging. However it may not present actual usage of nutrition information. A review of research on food labels (Cowburn and Stockley 2005) found that while reported consumer usage of food labels is high, their actual use appears to be much lower.
Familiarity with the product, time pressures and assumed knowledge can all affect whether or not a food label is used. To attempt to identify actual understanding and use of labels in a real life setting, AFIC's research tested various nutrition labels on actual meal choices.
What type of label is best understood?
There are many ways to provide more information on food labels. Most commonly, information is provided in the nutrition information panel which is found on the side of the food package. This panel provides information on calories/kilojoules, protein, fat, carbohydrate and sometimes provides additional information on other nutrients such as vitamins and minerals.
More recently other types of labels have been investigated, especially labels which can be placed on the front of the food package and which aim to summarise the important information on the nutrition side panel.
AFIC tested three types of nutrition labels – multiple traffic lights (MTL), Guideline Daily Amount (GDA) and energy content (EC) per serving. The MTL label uses "traffic lights" – red, amber and green circles – to depict the relative amounts of calories, fat, sugar and sodium. This is the type of label currently being promoted by the Food Standards Agency, UK, as a good model as it is thought to be simple to understand.
However the AFIC research showed that most consumers in the Bangkok and Shanghai study did not understand the colour coding at all. While respondents in Bangkok could identify the amount of nutrient in the food, they could not tell whether this level was high, moderate or low. In Shanghai, understanding of any of the information on the MTL panel was poor.
The GDA label listed the amount of calories, fat, sugar and sodium in a serving of the food as well as the percentage contribution to recommended daily intakes. Many manufacturers in Europe are using this type of label on foods and beverages in an effort to provide consumers with easy to understand information.
The AFIC study showed that the GDA label appeared to be better understood in Bangkok, with some respondents correctly interpreting meals as high or low in certain nutrients. However the level of understanding was low in the Shanghai group.
Finally, most respondents in Bangkok could correctly state the calories in a meal when shown the energy-based or energy content (EC) label. However they did not appear to understand the 2000kcal daily requirement listed on the label. Once again, understanding in Shanghai was poor.
Basic nutrition knowledge is poor
The AFIC study also looked at basic knowledge on energy levels of various foods and daily energy requirements. A significant number of public health programmes in Asia now involve information on weight management because of the soaring levels of overweight.
Yet the AFIC study showed that most respondents did not know their average daily energy needs. Knowledge on the calorie levels of various foods and beverages was also poor in both markets. Non-readers of food labels, those with lower education levels and teenagers were more likely to answer incorrectly or say they didn't know.
In both cities there was confusion over the terms "energy" and "calories". In Bangkok, "energy" was perceived as positive in the MTL and GDA labels but as negative in the energy-based labels. In Shanghai, there was a misunderstanding that the calories on the label came entirely from fat or that "energy" meant "heat energy".
Sodium was not understood by about one in three respondents in both cities.
Key learnings
When providing more information on nutrition and food choices for consumers, the study provided some interesting learnings, including the following:
·The main source of calories in both Bangkok and Shanghai come from non-packaged foods. Efforts to address overweight and obesity by providing more nutrition information needs to focus on the major contributors to calorie intake. The provision of information on and about foods from wet markets, street foods and hawker foods would appear to offer the best opportunity to help consumers make more informed food choices.
·Many public health programmes are targeting weight management. It is well accepted that energy balance (and weight control) rests on the equation: Energy in = Energy out = Weight maintenance
Most consumers in this study did not know how many calories they needed in a day. Nor did they know the average calories in many foods and drinks. This information is needed for the people to be able to put weight maintenance recommendations and advice into practice. Information on energy needs and calorie levels of commonly consumed foods would help consumers in Bangkok and Shanghai choose foods which meet their calorie requirements.
·The main reason that people chose one particular meal over another was for taste. Nutrition was a secondary factor involved in food choice. The importance of nutrition in food choice varies by country and by consumer group. For example, people in Shanghai were much less likely to agree that they would change their eating habits if they had more nutrition information on foods than were those in Bangkok.
There are also various groups within populations that are more interested in receiving nutrition information than other groups – such as those with health problems, women, older people and the better educated. The effective targeting of public health programmes would need to take these factors into account when deciding on target groups, communication methods and key messages.
·The introduction of any form of food label in either Bangkok or Shanghai will require extensive education efforts to ensure consumer understanding. Further research is required on the most appropriate nutrition labels for use in Asia.
References:
1. Grunert and Wills 2007 A Review of European research on consumer response to nutrition information on food labels.
2. Cowburn and Stockley (2005) Consumer understanding and use of nutrition labelling: a systematic review. Pub Health Nutr 8:21-25
n This article is courtesy of the Asian Food Information Council's Food Facts Asia Issue 33.
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