Efeitos dos sistemas de rotulagem nutricional frontal brasileiro, mexicano e argentino na compra on-line de bebidas não alcoólicas e biscoitos salgados por adolescentes e na mudança de decisão de aquisição de alimentos e bebidas por meio de um aplicativo para celular em situação real de compra por adultos.

Abstract

The front-of-package nutrition labeling (FOPNL) systems are public health strategies aimed at improving food choices and reducing diet-related diseases. This study aimed to evaluate the effectiveness of FOPNL systems in food purchase abandonment (Study 1) in a real shopping scenario using a smartphone application, in a simulated purchase of non-alcoholic beverages (Study 2) and savory biscuits (Study 3) by adolescents on an experimental website.This research comprised three experimental, controlled, and randomized studies assessing the effects of Brazilian (magnifying glass "high in" design and Brazilian nutritional profile), Mexican (octagonal "excess of" design and Mexican nutritional profile), and Argentine (octagonal "excess of" design and Argentine nutritional profile) FOPNL systems. In Study 1, 397 participants (59.1% female, 42.9±14.4 years old) were randomized into three groups (control - nutrition facts table, Brazilian and Mexican FOPNL systems). They scanned 1,522 food and beverage products they intended to purchase and viewed the corresponding FOPNL via a smartphone application when applicable. They then reported their purchase decision. Studies 2 and 3 followed a similar design. Adolescents from public schools in the city of Contagem, MG, participated in a simulated online shopping experience for non-alcoholic beverages (Study 2) and savory biscuits (Study 3). Afterward, participants answered questionnaires about healthiness perception and identification of excessive nutrients. In Study 2, 437 adolescents (63.8% female, 16.2±0.9 years old) were randomly assigned to three groups (control – no FOPNL, Brazilian and Mexican FOPNL systems). In Study 3, 617 adolescents (56.2% female, 16.6±1.1 years old) were randomized into four groups (control – no FOPNL, Brazilian, Argentine, and mixed FOPNL systems – magnifying glass "high in" design, Brazilian-adopted nutrients, and cut-off points and area occupation per Argentine regulations). Results, Study 1: Viewing both FOPNL systems via the app increased the odds of purchase abandonment by 2.5 times. Abandoned products contained more added sugars under the Brazilian FOPNL system (21.3g/100g vs. 14.4g/100g, p<0.001) and higher levels of free sugars compared to the control (16.0g/100g vs. 14.4g/100g, p=0.013). Study 2: Compared to the control, participants in the Mexican FOPNL group selected beverages with 11.5% lower free sugar content, 10.3% lower added sugar content, and 7.7% lower energy density. The Brazilian FOPNL system reduced purchased calories by 2.3% but did not impact sugar selection. Additionally, the Mexican system increased the perception of sweetened beverages as harmful by 82%. However, neither the Brazilian nor Mexican FOPNL systems significantly improved the identification of excessive nutrients among adolescents purchasing sugary beverages. Study 3: The Argentine FOPNL system influenced adolescents to choose biscuits with a lower median sodium content (-99mg/100g) compared to the control and mixed groups, with no significant difference from the Brazilian system. Compared to the control, the Argentine (-2g/100g) and Brazilian (-1.8g/100g) FOPNL systems led to reductions in the saturated fat content of selected biscuits. However, FOPNL systems did not significantly impact the identification of excessive sodium and saturated fat, and only the Argentine system influenced healthiness perception. Conclusion: different FOPNL systems impact consumer food choices in distinct ways. Viewing FOPNL increased purchase abandonment, leading to higher levels of sugars being discarded. The Mexican system effectively reduced the selection of beverages with high sugar and energy density while influencing consumer perception of sweetened beverage risks. Regarding biscuits, the Argentine FOPNL system had the greatest impact on reducing sodium and saturated fat acquisition and improving healthiness perception. The Brazilian system influenced calorie reduction (in sweetened beverages) and saturated fat reduction (in savory biscuits). The mixed FOPNL system was ineffective in altering the evaluated outcomes. These findings underscore the importance of enhancing the Brazilian FOPNL system to maximize its effectiveness in promoting healthier food choices.