Hostname: page-component-797576ffbb-58z7q Total loading time: 0 Render date: 2023-12-08T17:20:07.108Z Has data issue: false Feature Flags: { "corePageComponentGetUserInfoFromSharedSession": true, "coreDisableEcommerce": false, "useRatesEcommerce": true } hasContentIssue false

Consumer understanding and use of nutrition labelling: a systematic review

Published online by Cambridge University Press:  02 January 2007

Gill Cowburn*
British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK
Lynn Stockley
British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK
*Corresponding author: Email
Rights & Permissions [Opens in a new window]


Core share and HTML view are not possible as this article does not have html content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

To explore published and unpublished research into consumer understanding and use of nutrition labelling which is culturally applicable in Europe.


A systematic review undertaken between July 2002 and February 2003.


One hundred and three papers were identified that reported on consumer understanding or use of nutrition labelling, most originating from North America or northern Europe. Only a few studies (9%) were judged to be of high or medium–high quality. We found that reported use of nutrition labels is high but more objective measures suggest that actual use of nutrition labelling during food purchase may be much lower. Whether or not consumers can understand and use nutrition labelling depends on the purpose of the task. Available evidence suggests that consumers who do look at nutrition labels can understand some of the terms used but are confused by other types of information. Most appear able to retrieve simple information and make simple calculations and comparisons between products using numerical information, but their ability to interpret the nutrition label accurately reduces as the complexity of the task increases. The addition of interpretational aids like verbal descriptors and recommended reference values helps in product comparison and in putting products into a total diet context.


Improvements in nutrition labelling could make a small but important contribution towards making the existing point-of-purchase environment more conducive to the selection of healthy choices. In particular, interpretational aids can help consumers assess the nutrient contribution of specific foods to the overall diet.

Research Article
Copyright © CABI Publishing 2005


1 Joint Food and Agricultural Organization of the United Nations (FAO)/World Health Organization (WHO) Food Standards Programme. Codex Alimentarius Food Labelling Complete Texts, revised 2001, Rome: FAO/WHO, 2001.Google Scholar
2 Council Directive 90/496/EEC on nutrition labelling for foodstuffs of 24 September 1990. Official Journal of the European Communities L276 of October 1990. Luxembourg: European Commission, 1990; 40–4.Google Scholar
3 The Food Labelling Regulations (UK). SI 1996 no.1449, as amended. London: Her Majesty's Stationery Office, 1996.Google Scholar
4 Ministry of Agriculture, Fisheries and Food (MAFF). Guidance Notes of Nutrition Labelling. London: MAFF, 1994.Google Scholar
5 US Food and Drug Administration (FDA). Guide to Nutrition Labelling and Education Act (NLEA) Requirements. Rockville, MD: FDA, 1994.Google Scholar
6Sibbald, B. Canada's nutrition labels: a new world standard? Canadian Medical Association Journal 2003; 168(7): 887.Google Scholar
7Curran, MA. Nutrition labelling: perspectives of a bi-national agency for Australia and New Zealand. Asia Pacific Journal of Clinical Nutrition 2002; 11(2): S72–6.Google Scholar
8Tee, ES, Tamin, S, Ilyas, R, Ramos, A, Tan, WL, Lai, DK, et al. Current status of nutrition labelling and claims in the South-East Asian region: are we in harmony? Asia Pacific Journal of Clinical Nutrition 2002; 11(2): S80–6.Google Scholar
9 Research Services Ltd. Nutrition Labelling Study. London: Ministry of Agriculture, Fisheries and Food, 1995.Google Scholar
10 Food and Drink Federation (FDF)/Institute of Environmental Health Officers (IEHO). The FDF–IEHO National Food Safety Report. London: FDF/IEHO, 1993.Google Scholar
11 Bureau Europeen des Unions de Consommateurs. Position Paper on the Labelling of Food. Brussels: Bureau Europeen des Unions de Consommateurs, 2001.Google Scholar
12Kafatos, AG, Codrington, CA, eds. Eurodiet Reports and Proceedings [special issue]. Public Health Nutrition 2001; 4(2A): 265436.Google Scholar
13 European Heart Network. Food, Nutrition and Cardiovascular Disease Prevention in the European Union. Brussels: European Heart Network, 1998.Google Scholar
14 Food Standards Agency (FSA), Food Advisory Committee. Review of Food Labelling 2001. London: FSA, 2001.Google Scholar
15 NHS Centre for Reviews and Dissemination. Report Number 4. 2nd ed. York: NHS Centre for Reviews and Dissemination, 2001.Google Scholar
17 European Heart Network. A Systematic Review of the Research on Consumer Understanding of Nutrition Labelling. Brussels: European Heart Network, 2003.Google Scholar
18Black, A, Rayner, M (Coronary Prevention Group). Just Read the Label. London: The Stationery Office, 1992.Google Scholar
19Guthrie, JF, Fox, JJ, Cleveland, LE, Welsh, S. Who uses nutrition labeling, and what effects does label use have on diet quality? Journal of Nutrition Education 1995; 27(4): 163–72.Google Scholar
20Higginson, C, Kirk, TR, Rayner, M, Draper, S. How do consumers use nutrition label information? Nutrition and Food Science 2002; 32(4): 145–52.Google Scholar
21Higginson, C, Rayner, M, Draper, S, Kirk, TR. The nutrition label – which information is looked at? Nutrition and Food Science 2002; 32(3): 92–9.Google Scholar
22Levy, A, Fein, S. Consumers' ability to perform tasks using nutrition labels. Journal of Nutrition Education 1998; 30(4): 210–7.Google Scholar
23 National Institute of Nutrition. Nutrition Labelling: Perceptions and Preferences of Canadians 9. Ontario: National Institute of Nutrition, 1999.Google Scholar
24Neuhouser, ML, Kristal, AR, Patterson, RE. Use of food nutrition labels is associated with lower fat intake. Journal of the American Dietetic Association 1999; 99(1): 4553.Google Scholar
25Paterson, D, Zappelli, R, Chalmers, A. Food Labelling Issues – Consumer Qualitative Research. Canberra: Australia and New Zealand Food Authority, 2001.Google Scholar
26Wyn Thomas, B, Boaz, A, Rayner, M. Food Labelling and Healthy Food Choices. Oxford: British Heart Foundation Health Promotion Research Group, 1997.Google Scholar
27Byrd-Bredbenner, C, Wong, A, Cottee, P. Consumer understanding of US and EU nutrition labels. British Food Journal 2000; 102(8): 615–29.Google Scholar
28Byrd-Bredbenner, C, Alfieri, L, Wong, A, Cottee, P. The inherent educational qualities of nutrition labels. Family and Consumer Sciences Research Journal 2001; 29(3): 265–80.Google Scholar
29Byrd-Bredbenner, C, Kiefer, L. The ability of elderly women to perform Nutrition Facts label tasks and judge nutrient content claims. Journal of Nutrition for the Elderly 2000; 20(2): 2946.Google Scholar
30Li, F, Miniard, PW, Barone, MJ. The facilitating influence of consumer knowledge on the effectiveness of daily value reference information. Journal of the Academy of Marketing Science 2002; 28(3): 425–36.Google Scholar
31Sullivan, AD, Gottschall-Pass, KT. Food label nutrition literacy: tool development and assessment. Journal of the Canadian Dietetic Association 1995; 56(2): 6872.Google Scholar
32 Institute of Grocery Distribution (IGD). Voluntary Nutrition Labelling. Watford: IGD, 1998.Google Scholar
33Byrd-Bredbenner, C. Designing a consumer friendly nutrition label. Journal of Nutrition Education 1994; 26: 180–90.Google Scholar
34 Co-operative Wholesale Society Ltd Putting the Consumer First. London: Co-operative Wholesale Society Ltd, 1993.Google Scholar
35 Food Standards Agency (FSA). Nutrition Labelling: Qualitative Research. London: FSA, 2001.Google Scholar
36Levy, AS, Fein, SB, Schucker, RE. Nutrition labelling formats: performance and preference. Food Technology 1991; 116–21.Google Scholar
37Lewis, CJ, Yetley, EA. Focus group sessions on formats of nutrition labels. Journal of the American Dietetic Association 1992; 92(1): 62–6.Google Scholar
38Mohr, KG, Wyse, BW, Hansen, RG. Aiding consumer nutrition decisions: comparison of a graphical nutrient density labeling format with the current food labeling system. Home Economics Research Journal 1980; 8(3): 162–72.Google Scholar
39Rudd, J. Aiding consumer nutrition decisions with the simple graphic label format. Home Economics Research Journal 1986; 14(3): 342–6.Google Scholar
40Byrd-Bredbenner, C, Alfieri, L, Kiefer, L. The nutrition label knowledge and usage behaviours of women in the US. BNF Nutrition Bulletin 2000; 25: 315–22.Google Scholar
41Klopp, P, MacDonald, M. Nutrition labels: an exploratory study of consumer reasons for non-use. Journal of Consumer Affairs 1981; 15: 301–16.Google Scholar
42 British Market Research Bureau. Consumer Attitudes to and Understanding of Nutrition Labelling: Quantitative Stage. London: Consumers' Association, 1985.Google Scholar
43Yeomans, Y. Practical use of nutrition labels. BNF Nutrition Bulletin 1986; 11: 1222.Google Scholar
44 European Commission Report of the Application of Directive 90/496/EEC on Nutrition Labelling for Foodstuffs. Brussels: European Commission, 2002.Google Scholar