A picture tells a thousand words: Impact of an educational nutrition booklet on nutrition label gazing
Overweight and obesity are major health issues in many countries. Nutritional labels provide a means to making healthier food choices. Gazing longer at nutrition labels rather than the products' packaging may be a first step in making a healthy decision when purchasing or consuming a product. Using eye-tracker methodology, we examined the influence of an educational nutrition booklet on duration of gaze at nutrition labels. Thirty-two adults from New York City participated in a pretest–posttest study. Participants were randomly assigned to the nutrition education group (NE) or the control group for 10 min. The NE group reviewed a picture-based educational nutrition booklet. The control group worked on a word find puzzle. Participants' duration of gazing at nutrition labels was assessed. Results revealed a significant interaction of group and nutrition label gazing such that the NE group gazed significantly longer at the nutritional label in the posttest compared to the pretest. The NE group gazed significantly longer at nutrition labels during the posttest than the control group. There was no effect for the control group. The findings show that briefly reviewing an educational nutrition booklet increases duration of gaze at nutrition labels.
KeywordsNutrition education Nutrition fact labels Eye tracker Marketing
Nutrition labels are used in many countries around the world. However, many adults do not understand nutrition labels (Rothman et al. 2006; Levy and Fein 1998; McArthur et al. 2001). This is especially problematic due to the alarming rates of obesity and their associated health risks. It is also relevant for health-care providers, diet programs, and companies promoting healthier food choices.
There are many reasons for misinterpretation of labels, such as misapplication of serving size, confusion due to irrelevant material, and incorrect calculations (Rothman et al. 2006). Complex math also makes it difficult for consumers to implement the information on nutrition labels into their daily diet (Levy and Fein 1998). Research shows that individuals who read nutrition labels have healthier diets (Kreuter et al. 1997). Thus, nutrition label education may benefit consumers by improving their dietary behavior.
Product packages often contain nutrition-related claims, which greatly alter a consumer's perception of serving size and food intake (Wansink and Chandon 2006). Consumers who see products labeled as low fat were more biased in their estimates in appropriate serving size than those who saw regular labels (Wansink and Chandon 2006). Also, low-fat product claims also lead to an increase in food intake during a single consumption by 50 % (Wansink and Chandon 2006). Consumers cannot rely on product packaging for accurate nutrition information. This is particularly important for overweight individuals who tend to consume more than the suggested serving size (Wansink and Chandon 2006; Wansink et al. 2011). Thus, consumers must focus on nutrition labels rather than product packaging in order to improve their dietary behavior.
Researchers have used eye-tracker technology to examine nutrition label use. Eye tracking technology allows researchers to collect concrete data on nutrition label gazing. An individual's location and duration of gaze are tracked by using high-speed, high-resolution cameras (Duchowski 2007). The eye tracker collects more unbiased data on gazing behavior; it is an excellent tool to examine the influence of an educational nutrition booklet on nutrition label gazing.
Products with more crowded packing design can reduce gazing at nutrition labels (Visschers et al. 2010). Thus, it is important for consumers to make informed health decisions based on nutrition labels rather than product packing when purchasing and consuming a product. Gazing longer at the nutrition label versus the product packaging is a likely first step in making a healthy decision when purchasing or consuming a product.
We hypothesize that a brief exposure to a picture-based educational booklet would influence gazing at nutrition labels.
2 Study methodology
2.1 Research setting and sample
Thirty-two undergraduate students (12 males, 20 females) were recruited and completed the study. An additional six subjects were tested, but excluded due to insufficient eye tracking data. All the participants were 17- to 24-year-old college students living in the New York City area.
2.2 Design and procedure
The booklet utilizes a “thumbs up” icon for healthy choices (e.g., cereals low in sugar and high in fiber) and a “thumbs down” icon for unhealthy choices (e.g., cereals high in sugar and low in fiber). Participants in the control group were asked to complete a word find puzzle with a beach theme for 10 min. The words were simple and consistent with the word level of the nutrition booklet. Most participants completed the word find puzzle within the 10 min; others could not locate one or two words. The same succession of five cereal boxes was displayed on the screen for the posttest. The participants' eye position and movement were recorded for the posttest.
Brief exposure to a picture-based educational nutrition booklet can increase duration of gazing at nutrition labels. Participants who reviewed the educational nutrition booklet for 10 min gazed significantly longer at the nutrition label during the posttest than the pretest. The NE group also gazed significantly longer at the nutrition label during the posttest than the control group.
Nutrition label reading is difficult and complex. Consumer education is needed in order to make more informed and healthier food decisions (Rothman et al. 2006; Goldberg et al. 1999). However, it would be more effective to simplify nutrition label reading for consumers. This study shows that use of picture-based labels, such as “thumbs up” along with the traditional nutrition label, may help adults make more informed and healthier food choices.
Consumers process visual and verbal information differently, and there is no clear theoretical formulation of the combined influence of visual and verbal information on information processing (Wyer et al. 2008). However, using a combination of visual and verbal information on product packaging may improve the consumers' ability to process the nutritional information and thus improve their dietary decision. Picture-based nutrition education booklets may be a cost-efficient way to provide nutrition education. A picture-based educational nutrition booklet may help to promote the use of nutrition labels in order to make a more informed health decision in purchasing and consuming food products.
Our study shows that nutrition education can increase the duration of gaze at nutrition labels. It is essential for consumers to comprehend labels in order to incorporate the nutritional information into their daily diet. Future work should investigate the booklet's impact on the participant's level of nutritional comprehension. More data are also needed on the effect of even shorter exposure times. For instance, could minimal exposure to nutritional educational images on food packaging influence decision making?
Society is becoming increasingly overweight and obese due to poor food choices and dietary behaviors. The long-term trends in obesity put into question the effectiveness of nutrition labels at motivating shoppers to make healthier choices. The current study shows consumers naturally gaze toward product packaging rather than nutrition labels. However, after reviewing the picture-based nutrition education booklet, consumers increased duration of gaze at nutrition labels. Picture-based education may improve consumer's food selection and dietary behavior. Future research is needed to address these questions. Gazing at relevant nutritional information may be a first step in improving consumer's food selection and dietary behaviors.
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