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Perception of different formats of front-of-pack nutrition labels according to sociodemographic, lifestyle and dietary factors in a French population: cross-sectional study among the NutriNet-Santé cohort participants
  1. Chantal Julia1,2,
  2. Sandrine Péneau1,
  3. Camille Buscail1,
  4. Rebeca Gonzalez1,
  5. Mathilde Touvier1,
  6. Serge Hercberg1,2,
  7. Emmanuelle Kesse-Guyot1
  1. 1 Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidemiologie et Biostatistiques Sorbonne Paris Cité (CRESS), Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne-Paris-Cité, Bobigny, France
  2. 2 Département de Santé Publique, Hôpital Avicenne (AP-HP), Bobigny, France
  1. Correspondence to Dr Chantal Julia; c.julia{at}


Objective Four formats for a front-of-pack (FOP) nutrition label are currently considered in France: the Nutriscore (or 5-Colour Nutrition Label, developed by a public research team), the SENS (supported by retailers), Multiple Traffic Lights (MTL, currently used in UK) and a modified version of the Reference Intakes (mRIs, supported by industry). Our objective was to investigate the perception of these FOP labels, according to sociodemographic, lifestyle and dietary factors.

Design Cross-sectional study.

Setting Web-based French cohort.

Main outcome measure FOP labels perception.

Participants Participants in the NutriNet-Santé cohort received a specific questionnaire on the perceptions of the four label formats identified. Sociodemographic, lifestyle and dietary data (three 24-hours dietary records) were collected through self-administered questionnaires. Mutually exclusive clusters of FOP labels perception were identified through a multiple correspondence analysis followed by a hierarchical clustering procedure. Sociodemographic, lifestyle and dietary factors associated with the clusters were explored using multivariable multinomial logistic regression. All analyses were weighted according to 2009 French census data.

Results Among the 21,702 participants in the study, the Nutriscore received the most important number of favourable responses on positive perception dimensions by participants, followed by MTL and SENS. The five identified clusters were characterised by marked preferences for Nutriscore (cluster 1, 43.2% of participants, crude n=9,399), MTL (cluster 2, 27.3%, crude n=6,163), SENS (cluster 3, 17.05%, crude n=3,546), mRIs (cluster 4, 7.31%, crude n=1,632) and none of the presented formats (cluster 5, 5.10%, crude n=965). The cluster 1 (Nutriscore) was associated with lower adherence to nutritional recommendations, while cluster 2 (MTL) was associated with younger age and higher level of education.

Conclusion The Nutriscore appears to have a wide reach in the population and to appeal to subjects with lower adherence to nutritional recommendations.

  • front-of-pack nutrition labels
  • perception
  • public health policy

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  • Contributors CJ wrote the statistical analysis plan, analysed the data and drafted and revised the paper. She is the guarantor. EKG participated in statistical analysis plan, analysed the data and critically revised the paper for important intellectual content. MT, CB, SP and RG analysed the data and critically revised the paper for important intellectual content. SH designed data collection tools, implemented the study, monitored data collection for the whole study and critically revised the draft paper for important intellectual content. All authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. All authors have read and approved the final manuscript.

  • Funding The NutriNet-Santé Study is supported by the French Ministry of Health, the Institut de Veille Sanitaire, the Institut National de la Santé et de la Recherche Médicale, the Institut National de la Recherche Agronomique, the Conservatoire National des Arts et Métiers, the Institut National de Prévention et d'Education pour la Santé and the Fondation pour la Recherche Médicale and Paris 13 University. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.Study sponsors had no part in study design, collection, analysis and interpretation of data and the writing of the article and the decision to submit it for publication. Researchers are independent from funders and sponsors. All researchers had access to all the data.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Institutional Review Board of the French Institute for Health and Medical Research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All necessary information is available in the paper.

  • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.