How do front of pack nutrition labels affect healthfulness perception of foods targeted at children? Insights from Brazilian children and parents

The inclusion of front of pack (FOP) nutrition labels is one of the strategies that has been proposed to encourage people to make healthful food choices, helping to cope with the increasing burden of overweight and obesity among adults and children. The aim of this study was to evaluate the effect of different FOP labels on Brazilian children and parents' healthfulness perception. Children aged 6-12 years (n = 318) and parents (n = 278) with different socio-economic status rated their perceived healthfulness of eight food products targeted at children using a 7-point scale (1 = not healthful and 7 = very healthful). Participants were randomly allocated into one of the three groups of FOP nutrition labels: Daily Guideline Amounts (GDA), Traffic Light System (TLS) and warning system. Data were analyzed using analysis of variance. For parents, products with the warning system were rated significantly less healthful than those containing the GDA, whereas the TLS did not significantly differ from the other two systems. Age and socio-economic status influenced the effect of FOP labels on children's perceived healthfulness. Only 9-12 years old children from middle/high socio-economic status were influenced by FOP labels: the warning system and TLS reduced healthfulness perception of frosted corn flakes compared to the GDA system. These results suggest that directive and semi-directive FOP have the potential to modify healthfulness perception of products targeted at children and stress the need to study the modulating effect of individual variables such as age and socio-economic status on the perception of FOP labels.