Action on Salt and Sugar is calling for the UK government to make front-of-pack nutrition labels mandatory without delay following a systematic review and meta-analysis. The review found that interpretive front-of-pack labeling (FoPL) is considered a cost-effective strategy to promote a healthy diet and prevent diet-related disease.

The review and analysis were led by the researchers from Action on Salt and Sugar based at the Wolfson Institute of Population Health, Queen Mary University of London.

“Mandatory front of pack labels will ensure that all manufacturers put the nutrition information on product packaging. They will need to be honest about the salt, sugar, and saturated fat levels in their products. If a manufacturer has to put lots of red labels on the front of a pack, they may be more inclined to improve their recipes so that they can display amber or green labels instead,” Mhairi Brown, policy and public affairs manager, Action on Salt and Sugar tells NutritionInsight.

“We need robust policies to make sure that our food system and the world around us enables us to eat healthier options, and front of pack labeling is a key tool for consumers. We deserve to know what is in our food at a glance.”

Eye on nutrition labeling
The call for mandatory front-of-pack nutrition labeling will help consumers make healthier choices while encouraging healthy formulations from industry. 

The review found that the UK’s Traffic-light Labeling System (TLS), Nutri-Score (NS), Chile-style Nutrient Warning labels (NW) and Health Warnings (HW) were all able to direct consumers toward more healthy purchases.

The interpretive FoPL systems led to consumers reducing food purchases high in salt, fat or saturated fat content.“Despite the variation in label types, labeling formats, position, study population, study design and experimental settings across studies, our comprehensive systematic review and meta-analysis support the call for color-coded front-of-pack nutrition labels, which all have positive effects on guiding consumers in making more healthful food choices,” says lead author Dr. Jing Song.

“Food manufacturers must now get on board in efforts to improve the nation’s health by committing to putting FoPL across all their food and beverage products and on menus.”

Action on Salt and Sugar recommends TLS for the Out of Home sector as part of their response to the National Food Strategy. 

The scheme should be evaluated in real-time to assess effectiveness in helping to prevent obesity and diet-related diseases such as stroke, heart attacks and various cancers, notes the organization.

In May, Action on Salt called for labeling restrictions on “healthy snacks” that contained high amounts of sodium. Previously, Kellogg’s UK reduced its children’s cereal sugar and salt content by 10% and 20%, respectively.

Leading consumers toward healthier options 
The interpretive FoPL systems could direct consumers toward more healthy purchases, reducing the energy, salt, fat or saturated fat content of processed foods and drinks chosen or purchased. 

“Policies that encourage food manufacturers to improve what goes into the foods we buy will help improve the nation’s diet. Suboptimal diets are a leading risk factor for death and disability, and COVID-19 has reinforced how vital it is for the government to break the junk food cycle,” asserts Graham MacGregor, chair of Action on Salt and Sugar.

“The government must commit to the mandatory front of pack nutrition labeling as part of their response to the National Food Strategy – alongside comprehensive and strictly monitored reformulation programs – to support the nation’s health.”

The network meta-analysis summarized the currently available 134 studies, nested in 120 peer-reviewed articles, to updat the knowledge of the most mainstream ‘interpretive’ front-of-pack nutrition labeling schemes – those that use colors, symbols or graphics to aid consumers in understanding nutrition information.

The review was published in the PLOS Medicine Journal.

Lacking concrete evidenceExisting nutrition label research focuses on short-term computer simulations.
Last year, the UK government consulted on front of pack nutrition labels, inviting views on the current Traffic-light Labeling System and a potential move to NS or NW labels.

However, this study found that much of the existing nutrition label research focuses on short-term computer simulations. This research suggests future studies should focus on the real-world impact of nutrition labels on individuals’ eating patterns and industrial reformulation at the population level over a longer timeframe. 

“The government’s recent consultation on front-of-pack nutrition labels invited views on different labeling formats but did not indicate their intention to make labels mandatory. This research provides clear evidence that labeling works,” explains Brown.

Prior to this study, evidence on the impact of each type of color-coded label and warning labels on modifying consumers’ purchasing behaviors was mixed. 

This research demonstrates that all interpretive nutrition labels support consumers. However, color-coded labels (TLS and NS) perform better in highlighting positive aspects of products and encourage consumers to purchase healthier products.

In contrast, warning labels (NW and HW) put the negative aspects of products front and center, which discourages the purchase of less healthy products.