Literature review on consumer knowledge, attitudes and behaviours relating to sugars and food labelling

Executive summary

Food Standards Australia New Zealand (FSANZ) has undertaken a literature review to examine consumer knowledge, attitudes and behaviours relating to sugars in foods and as presented on food labelling. The purpose of a literature review is to assess the evidence as it presently stands in the available literature.The literature sourced for this review is of varying quality and uses different methodological approaches. Given the limitations of the literature this review does not aim to draw definitive conclusions. However, the findings from the literature, when taken together, do point towards some consistent findings regarding sugars, labelling and consumers' understanding and behaviour.

consumers are concerned about the sugar content of food. They believe that consumption of sugar is associated with negative health outcomes, such as weight gain. consumers who are attempting to reduce their sugar intakes report limiting their consumption of food categories they consider being high in sugar (e.g. sugar-sweetened beverages (SSBs)) and reading food labels. However, there is some evidence that consumers underestimate the sugar content of beverages containing fruit and other food groups. This may be due to the perceived healthiness and contextual understanding of fruit and other food groups such as vegetables.

Consumers do not understand what 'added sugars' are. When asked, consumers tend to report negative attitudes towards added sugars. However, they are not able to classify particular sugars as 'added' or 'natural'. This appears to be related to consumer associations between types of sugars and the perceived degree of refinement. Sugars such as honey are considered less refined, and therefore more natural and not 'added'.

The literature review has found mixed evidence regarding whether Australian and New Zealand consumers can use current labelling to make informed choices with respect to sugar. Their ability to use labelling depends on the type of task they are completing. When given a comparison task, consumers are capable of identifying which of two products is lower in sugar. However, international research suggests consumers generally aren't able to use abstract information such as grams of sugar listed on a label to evaluate whether a food is high or low in sugar. As such, consumers may not completely comprehend the high quantity of sugar in foods such as SSBs or confectionary items. Even though the majority of consumers understand that a food carrying a 'no added sugar' claim may contain naturally occurring sugar, the claim can lead some consumers to incorrectly conclude that the food does not contain any sugar.

There is a limited volume of research examining the interaction between labelling and consumer choices in relation to sugar. However, the review identified some evidence that the inclusion of added sugars as a separate element on nutritional labelling may lead some consumers to overestimate the sugar content of a food item. This occurs where consumers believe 'added' sugars are in addition to the 'total' sugar content. Furthermore, the inclusion of 'added' sugar on nutrition labelling may lead some consumers to place too much emphasis on sugar, resulting in less accurate evaluations of a food's overall healthiness.

Although the above is true for most consumers, a possible exception is consumers who are highly motivated to read and use food labels. consumers with higher nutritional knowledge and health interests appear more motivated to use nutrition labelling in regards to sugar content. Such consumers appear to compare products more frequently and find utility in nutrition labelling as well as interpretive labelling, such as the Health Star Rating and Traffic Light Labels.

Finally, despite the general lack of evidence of impact of sugar labelling on behaviour, in the case of SSBs, there is evidence that some labelling interventions may reduce purchase intentions for, and actual purchases, of SSBs.

The above findings taken together indicate that consumers' pre-existing interest in sugar influences both the awareness of the sugar content in food, as well as an understanding of the health effects of sugar consumption. Individual factors such as health conciousness and personal motivation are key drivers of consumer use of nutritional labelling and consumption behaviours. For those who are motivated to use labels to select items lower in sugar, the findings suggest they can use current labelling to do so. There is little evidence to suggest that nutritional labelling changes behaviour.

Given the limited evidence available, further research in relation to Australian and New Zealand's consumers response to various forms of sugar labelling could be beneficial.

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