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Patient understanding of food labels

Survey
Results
Comment

To many of us, information about healthy living is fairly straightforward. Don't smoke, exercise, eat fruit and vegetables, have fish in our diet, avoid too much salt, and drink alcohol in moderation. Many people eat processed or convenience foods, which are often higher in fats, salt, and sugar. It seems easier to avoid them than to try and work out from the labels how much fibre, fat, sugar, and calories they contain. A survey indicates that a substantial minority have significant difficulty in doing this [1].

Survey


The survey was carried out in Baltimore, using a convenience sample of 200 patients recruited from an academic primary care clinic who were aged 18 to 80 years. Those with poor vision, mental problems, or who could not speak English were excluded.

Patients completed a questionnaire on demographics and nutritional behaviour, validated health literacy and mathematics measures, and a nutritional survey. Questions on the survey used actual food labels, and included questions about determining carbohydrate or calorie content of an amount of food or beverage.

Results


Two hundred patients completed the survey. Most (72%) were women, and their average age was 43 years. They had a spread of education and family income, and most used food labels at least weekly.

On average, 69% of the food label questions were answered correctly. The most common mistakes concerned incorrect serving sizes, incorrect calculations, and confusion from extraneous information on the label. As an example, 68% could not correctly determine the number of calories in drinking a bottle of soda with contained 2.5 servings. Greater comprehension was correlated with higher income and education, and greater literacy and numeracy skills.

Comment


Many of us will not be surprised by this result, which probably applies just as much to the population at large as to an outpatient population. It emphasises that even people with higher literacy and numeracy skills have problems with food labels. Healthy living is more difficult for people with lower education, and lower income. Providing better and more understandable information on packaged food and drink is probably just as important as for medicines. Literacy and numeracy skills should be taken into account

Reference:

  1. RL Rothman et al. Patient understanding of food labels. Role of literacy and numeracy. American Journal of Preventive Medicine 2006 31:391-398.

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