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Meta-Analysis
. 2019 Feb;56(2):300-314.
doi: 10.1016/j.amepre.2018.09.024. Epub 2018 Dec 17.

A Meta-Analysis of Food Labeling Effects on Consumer Diet Behaviors and Industry Practices

Siyi Shangguan  1 , Ashkan Afshin  2 , Masha Shulkin  3 , Wenjie Ma  4 , Daniel Marsden  5 , Jessica Smith  6 , Michael Saheb-Kashaf  7 , Peilin Shi  8 , Renata Micha  8 , Fumiaki Imamura  9 , Dariush Mozaffarian  10 ; Food PRICE (Policy Review and Intervention Cost-Effectiveness) Project
Affiliations
Meta-Analysis

A Meta-Analysis of Food Labeling Effects on Consumer Diet Behaviors and Industry Practices

Siyi Shangguan et al. Am J Prev Med. 2019 Feb.

Abstract

Context: The influence of food and beverage labeling (food labeling) on consumer behaviors, industry responses, and health outcomes is not well established.

Evidence acquisition: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Ten databases were searched in 2014 for studies published after 1990 evaluating food labeling and consumer purchases/orders, intakes, metabolic risk factors, and industry responses. Data extractions were performed independently and in duplicate. Studies were pooled using inverse-variance random effects meta-analysis. Heterogeneity was explored with I2, stratified analyses, and meta-regression; and publication bias was assessed with funnel plots, Begg's tests, and Egger's tests. Analyses were completed in 2017.

Evidence synthesis: From 6,232 articles, a total of 60 studies were identified, including 2 million observations across 111 intervention arms in 11 countries. Food labeling decreased consumer intakes of energy by 6.6% (95% CI= -8.8%, -4.4%, n=31), total fat by 10.6% (95% CI= -17.7%, -3.5%, n=13), and other unhealthy dietary options by 13.0% (95% CI= -25.7%, -0.2%, n=16), while increasing vegetable consumption by 13.5% (95% CI=2.4%, 24.6%, n=5). Evaluating industry responses, labeling decreased product contents of sodium by 8.9% (95% CI= -17.3%, -0.6%, n=4) and artificial trans fat by 64.3% (95% CI= -91.1%, -37.5%, n=3). No significant heterogeneity was identified by label placement or type, duration, labeled product, region, population, voluntary or legislative approaches, combined intervention components, study design, or quality. Evidence for publication bias was not identified.

Conclusions: From reviewing 60 intervention studies, food labeling reduces consumer dietary intake of selected nutrients and influences industry practices to reduce product contents of sodium and artificial trans fat.

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Conflict of interest statement

Dr. Mozaffarian reports funding from NIH and the Bill and Melinda Gates Foundation; personal fees from GOED, DSM, Nutrition Impact, Pollock Communications, Bunge, Indigo Agriculture, Amarin, Acasti Pharma, and America’s Test Kitchen; scientific advisory board, Omada Health, Elysium Health, and DayTwo; and chapter royalties from UpToDate; all outside the submitted work. Dr. Micha reports funding from the Bill and Melinda Gates Foundation, Unilever, personal fees from World Bank; all outside the submitted work. Dr. Smith completed the majority of the work related to this manuscript while a research fellow at the Harvard T.H. Chan School of Public Health. All the other authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Screening and selection process for intervention studies evaluating food labeling effects on consumer diet behaviors and industry practices.
See this image and copyright information in PMC

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