Developing and testing front-of-pack nutrition labels in India: An experimental study

The most populous country in the world, India, is experiencing a nutrition transition that involves rapidly increasing prevalence of unhealthy packaged foods. To assist consumers in making healthier packaged food choices, the Government of India is in the process of designing and implementing a new front-of-pack nutrition labelling system. The aim of this study was to provide insights into the types of labels that may be most effective across the diverse Indian population. A multi-method data collection process was employed that involved 16 focus groups (n = 112 adult participants) and a survey administered to 1,270 adults. The assessed outcome variables were objective understanding, food choice, and perceptions of labels. The five front-of-pack nutrition labels tested in the experimental survey were 2-colour and 3-colour versions of the Multiple Traffic Lights label, a colour version of the Health Star Rating label, a smiley face version of the Nutri-Score label, and red Warning Labels. All five assessed front-of-pack nutrition labels produced favourable effects for objective understanding, choice, and perception outcomes, but the 2-colour Multiple Traffic Lights label performed best across both objective understanding and choice outcomes. The results highlight the importance of including colour as an interpretation aid in the new front-of-pack nutrition label to be introduced in India.