Associations between health literacy and attention to food packaging, front of pack labels, and claims

Background: Poor diet is an important risk factor for chronic disease and obesity in the U.S. and diet related health disparities disproportionately affect race/ethnic minorities and adults with the lowest levels of income, education, and health literacy. Packaged foods contribute to poor diet by adding excess calories, saturated fat, sugars, and sodium. Nutrition labels and claims influence knowledge of the healthfulness and nutrient content of packaged foods, and may ultimately impact purchasing decisions. Objective: The purpose of this study was to investigate how adults with varying levels of health literacy view food packaging components. Sample: 25 University Staff and 25 Adult Education students were recruited for participation in the study. The final sample included 47 adults (24 University Staff and 23 Adult Education Students), with 61% of adults were between 25-44 years old, 77% were female, and 47% non-Hispanic White. Methods: Eye tracking technology was used to measure participant attention to food packaging stimuli. The Newest Vital Sign (NVS) was used to measure health literacy. Using objectively measured attention variables, in linear regression models, this study tested the relationship between health literacy and attention to food packaging, claims, and front of pack labels. Results: Health literacy was found to be positively associated with attention to food packaging (B = 13.52, SE = 6.06, p < .05) and front of pack labels (B = 0.29, SE = 0.12, p < .05). After controlling for education and race/ethnicity, health literacy remained positively associated with attention to food packaging (B = 17.01, SE = 8.45, p = 0.050) but not with front of pack labels. Conclusions: Health literacy may be an important factor influencing initial exposure to nutrition information on food packaging. Understanding attention to food packaging and nutrition labels for vulnerable populations, such as those with limited health literacy, is needed to inform strategies focused on increasing nutrition label use and comprehension.