Obesity Abstracts

Background: Excessive consumption of energy-dense food increases the risk of obesity, which in turn increases the risk of non-communicable diseases, including heart disease, type 2 diabetes and most non-smoking related cancers. Health warning labels (HWLs) that communicate the adverse health consequences of excess calorie consumption could reduce intake of energy-dense foods. We aimed to identify the most promising HWLs for reducing intake of energy-dense snacks in two online studies for subsequent testing in real-world settings.

Methods: Study 1: A between-subjects design with 18 different image-and-text HWL conditions. Participants (N=4618) were randomly allocated to view a food product with one HWL. HWLs rated as the most potent (based on high negative emotional arousal and low desire to consume the product) were selected for Study 2.

Study 2: A between-subjects, 3 (HWL: text only, image-and-text, no label) × 2 (calorie information; no calorie information), factorial experimental design. Participants (N=4134) were randomised to view a selection of low and high energy-dense snacks with one of five label types or no label. The primary outcome was the proportion of participants selecting energy-dense snacks in a hypothetical vending machine task.

Results: Study 1: HWLs illustrating bowel cancer, heart disease and type 2 diabetes were rated as the most potent and were selected for Study 2.

Study 2: Preliminary results show the proportion of participants selecting an energy-dense snack was reduced in all HWL conditions, relative to the control condition: (Image-and-text (37% selected energy-dense snack); Image-and-text with calories (38%); Text-only (48%); Text-only with calories (44%); Calories only (54%), Control (59%)). Participants were least likely to select an energy-dense snack in the image-and-text HWL condition and most likely in the control condition.

Conclusions: HWLs – particularly those including an image and text - have the potential to reduce selection of energy-dense snacks. Their impact on selection and consumption in real-world settings awaits testing.

Keywords: Health warning labels, pictorial labels, graphic warnings, snacks, food, choice architecture

Disclosures: The study investigators have no known conflicts of interest to declare.