Front-of-Packing Food Labeling System Leads to Healthier Choices

A novel front-of-pack food labeling system in Australia was found to be more useful and easier to understand than other labeling systems according to research presented on March 17 at ACC.17 in Washington, DC.

The Health Star Rating system, introduced by the Australian government in 2015, rates packaged food products using a scoring system of one to five stars and list the amount of calories, saturated fat, sugars and sodium in the product.

A total of 1,578 participants were randomly assigned to use one of four different forms of front-of-pack labeling to help them make healthier food purchasing decisions over one month – Health Star Rating, multi-colored traffic light labels, daily intake guides, and warnings – or to the control group which used the nutrient information panel. Participants accessed label information by using a smartphone application to scan bar-codes while shopping. The primary outcome was healthiness defined by the mean transformed nutrient profile score of packaged foods purchased.

The participants purchased over 200,000 food items during the study period. The mean healthiness of the purchases in the Health Star Rating group was non-inferior to the other rating systems (all p<0.01 at 2 percent non-inferiority margin). Compared to the control group, there was no difference in the mean healthiness of purchases for the Health Star Rating, traffic light labels or daily intake guides, but warning labels resulted in healthier packaged food purchases. Health Star Ratings were perceived as easier to understand that the traffic light labels and daily intake guides and were seen as more useful than all three of the other rating systems. Participants also reported that the Health Star Ratings were easier to understand, and along with the traffic light labels more useful, than the nutrient information panel used in the control group.

The researchers conclude that the findings support the Australian government choice to use the Health Star Rating system as the preferred front-of-pack labeling format. However, they suggest that adding warning and recommendation labels may lead to even healthier food purchases.


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