Nutrition labels lead to healthier eating in teens, study finds

In a recent study published in Nutrients, researchers at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin explored how nutrition labels affect eating behaviors among middle-school and high-school students in Texas.

Based on self-reported information, their results indicate that improving nutrition literacy and using food labels could significantly enhance the quality of diet for school-going adolescents.

Background

Nutrition labels can help people compare different food items and inform healthier decision-making. In recent years, the use of food labels has increased dramatically among American adults, with around 80% making purchase decisions based on label information. Using labels is related to better dietary quality and health outcomes.

Adolescent health is a policy priority since this period of life is critical for well-being in adulthood. Today, nearly one in four American adolescents are categorized as obese, but studies on nutrition label use among this group have shown contradictory results.

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

About the study

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

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

The students’ dietary behavior was assessed using questions on how frequently they reported consuming various food items the previous day. The list contained 13 healthy foods, such as brown rice, vegetables, whole fruit, and baked meat, and 13 unhealthy foods, such as flavored milk, fried meat, caffeinated beverages, and frozen desserts. To include weekday consumption, the food consumption surveys were administered from Tuesday to Friday.

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

Findings

The sample included 4,730 students, of whom 49% were female, more than half were Hispanic, and had an average age of 14.7 years old. Most students were not economically advantaged, and nearly 15% had limited English proficiency. About 60% reported that they never or rarely used food labels to make decisions about eating. Only 11% said they always relied on labels to make food choices.

The regression analyses showed that using food labels was significantly positively associated with HEI and HFI scores and negatively associated with UFI scores. The researchers observed a dose-response relationship where stronger associations were observed as the frequency of label use increased.

Individuals who consistently or almost always used the food labels were likelier to eat healthy foods such as nuts, brown bread, baked meat, fruit, and vegetables; they also reported consuming lower amounts of chips, soda, and candy.

Conclusions

The findings from this study clearly showed 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 the students made use of food labels all the time, indicating that not many are utilizing this resource.

Despite these benefits, many adolescents may struggle to understand the complex nutritional information on the labels. Using this information to guide food-related decision-making requires comprehending and responding to information on which nutrients should be avoided or limited (sodium, added sugars, and saturated fats) and those that are healthy (e.g., minerals and dietary fibers).

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

Future studies can explore the mechanisms behind the associations observed, how to encourage food literacy and label use among the youth, and explore possible sex-based differences to address the specific needs of female and male students.