Effectiveness of different front-of-pack nutritional labels in promoting greater adherence to the mediterranean diet among Italian consumers

The prevalence of obesity and non-communicable diseases is progressively increasing worldwide. To address this problem, in 2011, the European Commission declared its intention to adopt a common front-of-pack label (FOPL) to inform European consumers and enable them to choose nutritionally appropriate foods. Therefore, the aim of this study is to evaluate the effectiveness of two labels officially adopted by European countries. The study was designed as a randomized-controlled trial, consisting of three conditions: use of Nutri-Score label vs. use of Battery label vs. no label (control condition). 1900 Italian adult participants were asked to use for one month a mobile application to visualize food label information and orient their food choices. Adherence to the Mediterranean diet and nutrition knowledge were assessed before and after the intervention. Data showed low use of labels: more than 6 out of 10 consumers never used them during the 30-day intervention period. The ANOVA test showed no statistically significant differences among groups for adherence to the Mediterranean diet and nutrition knowledge before and after the intervention, as well as after a difference-in-difference regression analysis. Moreover, self-assessed nutrition knowledge and individual diet quality were overestimated by 3.9% and 17.6%, respectively. FOPLs showed no effectiveness in influencing participants' eating pattern. Future research should explore if the reasons that prevented Italian consumers from using FOPLs are consumer-related (i.e., nutrition knowledge and diet quality overestimations), label-related (i.e., complexity or extreme simplification in information), or related to other contributing factors (i.e., time available for food shopping, economic aspects). • Neither Nutri-Score nor NutrInform Battery appear to improve participants' eating behaviors. • Neither Nutri-Score nor NutrInform Battery appear to improve participants' nutrition knowledge. • Over 60% of participants did not use the labels during the study period. • Participants overestimated their nutrition knowledge and diet quality.