In a recent study published in Nutrientsresearchers at the University of Texas Health Science Center at Houston School of Public Health (UTHealth) in Austin explored how nutrition labels influence eating behaviors among middle and high school students in Texas.
Based on self-reported information, their results show that improving nutrition literacy and using food labels can significantly improve the quality of school-aged youth’s diet.
Nutrition labels can help people compare different food items and provide information for healthier decision making. In recent years, the use of food labels has increased dramatically among American adults, with approximately 80% making purchasing decisions based on label information. Use of labels is associated with better diet quality and health outcomes.
Adolescent health is a policy priority as this period of life is critical for adult well-being. Today, nearly one in four American teenagers are in the obese category, but studies of nutrition label use among this group have shown conflicting results.
Although one study found high levels of label use among adolescents, this did not equate to a healthier diet. Another found much lower levels of label use. These conflicting findings highlight the need for more 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 Texas Physical Activity and Nutrition Survey from 2019 to 2020. During the academic year, eighth and eleventh grade students filled out survey questionnaires and they answered questions about demographics. intelligence, 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 if they used food labels to guide their food choices. They were asked to respond on a five-point Likert scale ranging from ‘Always’ to ‘Never’. This was the main predictor.
The nutritional behavior of the students was assessed by using questions on how often they reported eating different 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 consumption during the week, 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 main outcomes of the study were the IAO index, HFI, and unhealthy foods (UFI). Data were analyzed using adjusted and weighted linear regression and logistic models.
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. Most students were not economically advantaged, and almost 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 analyzes 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 in which stronger associations were observed as the frequency of label use increased.
Individuals who used the food labels consistently or almost always were more likely 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.
The results of this study clearly demonstrated a dose-response relationship. The benefits of using food labels were greater for those who used them more often, and students who always used food labels had significantly healthier diets than other groups. However, only 11% of the students used food labels all the time, which indicates that not many of them are using this resource.
Despite these benefits, many young people may struggle to understand the complex nutritional information on labels. Using this information to guide food-related decision-making requires understanding and responding to information about which nutrients should be avoided or limited (sodium, added sugars, and saturated fats) and which are healthy (eg, minerals and dietary fibres).
Among the strengths of this study were its state-level representative design; however, the study was also observational, which did not allow causal inferences, and relied on self-report data, which is subject to recall and social desirability biases.
Future studies can explore the mechanisms behind the observed associations, how to encourage food literacy and label use among youth, and explore potential differences based on sex to address specific needs the female and male students.
- Pflederer C, Ranjit N, Perez A, et al. (2024). The nutrition facts label is used to make food choices with healthier food among 8th and 11th– grade students: analysis of state representative data from the 2019-2020 Texas school physical activity and nutrition survey. Nutrients. for me: 10.3390/N 16020311. https://www.mdpi.com/2072-6643/16/2/311