Elsevier

Public Health

Volume 147, June 2017, Pages 119-127
Public Health

Original Research
Investigation on the role of consumer health orientation in the use of food labels

https://doi.org/10.1016/j.puhe.2017.02.011Get rights and content

Highlights

  • The relationship of health orientation to nutrition label use frequency is explored.

  • Data were collected through face-to-face interviews of 540 Italian consumers.

  • Data were analysed through regression analysis.

  • Highly health-oriented consumers use nutrition labels more frequently.

  • Limited effect of nutrition labels on consumers that mostly would need to use it.

Abstract

Objective

This study explored the relationship between health orientation (i.e. individual motivation to engage in healthy attitudes, beliefs and behaviours) and consumers' use of nutritional information on food labels. Specifically, this study analysed the relationship between a number of direct investments in health (namely those behaviours that can contribute directly to maintain a good health status) and use of nutritional information on food labels.

Study design

Data for the analysis were collected through face-to-face interviews with a sample of 540 Italian consumers in charge of their grocery shopping. Forty grocery stores, including supermarkets and hypermarkets, were selected using a systematic sampling technique.

Methods

Data were analysed using three equations and accounting for endogeneity issues.

Results

This study found that those consumer groups with low health orientation (specifically smokers, those who do not exercise regularly, and those with an unhealthy body weight) show little interest in nutritional labels.

Conclusion

Nutritional labels as a tool to promote healthier food choices have a limited effect on those consumers in greatest need of pursuing healthier lifestyle habits. Alternative policy intervention should be undertaken to reach these consumer groups.

Introduction

Diet-related chronic diseases, such as overweight and obesity, have reached epidemic proportions in many developed and developing countries, and constitute a public issue not only from a medical point of view, but also in economic terms. These diseases generate negative externalities due to sizable sanitary costs and the reduced productivity of obese individuals.1 The obesity epidemic represents a concrete bankrupt threat for the medical systems of many countries,2, 3 denoting a major reason to take action and address consumers regarding healthier food choices.2, 4, 5, 6, 7 In this context, one possible measure of public intervention is represented by information, particularly nutritional labelling. Indeed, nutritional labels can play an important role as they convey information on the product characteristics that would otherwise be unknown to consumers.8 Such information represents an aid for consumers in making food choices, as it facilitates comparisons between alternative products, contributing to informed purchasing decisions.9 In light of the supportive role of nutritional labelling in improving food choices, many countries have promoted policy interventions requiring disclosure of nutritional information on food labels.10, 11 For instance, in 2011, the European Union revised its food labelling regulations and enacted European Union Regulation No. 1169/2011, which makes it mandatory to include nutritional information on all prepackaged foods.

However, there is still open debate regarding the effectiveness of nutritional labels as a tool to promote healthier food choices. There are two main issues discussed in the literature: (1) it remains unclear if the use of nutritional labelling actually leads to concrete changes in consumers' food choices; and (2) there are still open questions about if, and to what extent, consumers actually use nutritional labelling.

Indeed, with regard to the first aspect, contradictory findings still exist concerning the causal relationship between consumers' use of nutritional information and behaviours. That is, the use of nutritional labels does not necessarily lead to changes in consumers' purchasing intentions, or lead towards healthier food choices. For instance, Teisl et al.12 found that providing information to consumers does not always lead them to switch their food choices from unhealthy to healthier products. Moreover, as pointed out by Miller Soederberg and Cassady,13 most previous research was based on correlational data, making it unclear whether the use of food labels is able to result in healthier diets. On the contrary, a number of studies have provided consistent evidence about the positive relationship between the use of nutritional information and healthier food choices. For instance, Drichoutis et al.14 reported that consumers who use nutritional labelling are more likely to choose foods rich in fibre and vitamins, and to avoid sugary and fatty products. Similar results were provided by Neuhouser et al.,15 Kim et al.16 and Variyam.17 Loureiro et al.18 found that the use of nutritional labels was associated with reduced obesity, particularly among women.

As for the second aspect, previous studies demonstrated that several factors can affect consumers' willingness to make use of labelled information, such as sex, education, income, time constraints,19 label format and nutritional knowledge.20, 21, 22 In this context, another important—yet less extensively studied—determinant of individual willingness to make use of nutritional labels is represented by individual motivation to pursue health-oriented goals.

The economic framework of this paper was developed with the aim of exploring this latter aspect, focussing the attention on consumers' health orientation (HO) and its association with the frequency of use of nutritional labels. Health orientation is defined as individual motivation to engage in healthy attitudes, beliefs and behaviours,23, 24 and reflects the extent to which individuals value their own health. In other words, the higher the HO, the greater the individual willingness to engage in health investments, including diet-related investments.24 This paper examined if high (low) HO is related to high (low) frequency of use of nutritional labels, which often represents the main source of information available to consumers when purchasing foods.9 A better understanding of this relationship is relevant to extend current knowledge concerning the main drivers of consumers' willingness to use nutritional information. More detailed characterization of consumers based on their individual characteristics (i.e. their motivation to pursue healthy behaviours) would aid the development of more effective information-based food policies that target specific population segments and would provide valuable insights for creating a supportive food environment favouring healthier food consumption.

This article is structured as follows: the next subsection describes the economic framework followed in this study, based on Grossman's model of the demand for health; the second section explains the details of data collection and the methodology applied; the third section provides the results and, finally, the article ends with a discussion of the results obtained, the limitations and the authors' suggestions for future research.

In the past, researchers have attempted to model the use of labels following different approaches.12, 25 Some of these attempts, such as that adopted by Drichoutis et al.,26 have been based on Grossman's model of the demand for health.27 This model is built around the proposition that health can be considered ‘as a durable capital stock that produces an output of healthy time’.27 The model assumes that individuals are endowed with an initial stock of health that is subject to depreciation over time and can be increased through investments.

On these grounds, the authors developed an economic framework in which the use of nutritional labels is considered as one of the possible investments that individuals can make to offset their health depreciation. To illustrate, consider the example of an individual who derives utility from his/her working time (W), his/her non-working time (F), his/her individual health condition (H) and the consumption of a bundle of other goods (G). This utility function can be written as:U=U(W,F,H,G)

According to Grossman,27, 28 the health component in Eq. [1] is a source of utility for the individual, as being in good health increases the productivity of working time and allows the enjoyment of a number of activities outside of work. However, Grossman's model also states that the individual health capital depreciates over time. In detail, ‘it is assumed that individuals inherit an initial stock of health that depreciates over time—at an increasing rate, at least after some stage in the life cycle—and can be increased by investment. Death occurs when the stock falls below a certain level, and one of the novel features of the model is that individuals ‘choose’ their length of life’.27 As such, in this model, health is not only demanded as consumption good to maximize the utility function but also produced by individuals through health-enhancing activities. Thereby, the health function can be expressed as:H=H(IH,Ω)where IH corresponds to investments in health and Ω represents a number of exogenous factors that can influence one's health condition independently from his/her willingness to invest in health (e.g. nature, genetics). Following Grossman, individuals can make different types of health investments, and IH can be divided into two components: Id (direct investments in health) and Ii (indirect investments in health). Hence, the health function can be expanded as:H=H(Id,Ii,Ω)

In this article, non-smoking behaviour (S), physical activity (PA) and the maintenance of a healthy weight (W) are considered as Id. Hence, the Id component in Eq. [3] can be rewritten as the summation of the aforementioned investments:Id=S+PA+W

On the other hand, the Ii component is represented by use of nutritional labels (L), which can be seen as an indirect investment as the use of labels can improve ones' health condition without affecting physiological functions directly. Thus:Ii=L

Within this economic framework, the use of information on labels can be considered as a source of health capital.29 In line with the aim of this article to understand if HO is related to the frequency of use of nutritional labels, this study will further focus on L and its relationship with the direct investments in health described in Eq. [4]. Specifically, L can be expressed by the function:L=L(Id,Ω)in which Ω is a bundle of factors different from HO that can affect the use of nutritional labels. These include nutritional knowledge, a proxy variable for time constraints and sociodemographic and economic variables. Indeed, the economic literature indicates that these are some of the key factors that must be taken into consideration while studying the use of nutritional labels. Thus, L is expressed as:L=L(Id,KN,T,S)where KN is nutritional knowledge, T represents the average time spent choosing a new food product and S refers to sociodemographic and economic variables.

The nutritional knowledge component included in the label function in Eq. [7] may represent a source of endogeneity in the equation.20, 30, 31 To account for the endogeneity issue, the KN function is defined as:KN=KN(X,Ei)where X is a vector of observable individual characteristics and Ei represents the unobservable characteristics of nutritional knowledge. Based on the main evidence in the economic literature, sociodemographic and economic conditions,31, 32 time spent choosing a new food product, and some sources of food-related information different from labels (i.e. information from television, internet and doctors/nutrition experts) are included in the vector X.30 Hence, following the approach adopted by Nayga,21 KN is treated as an endogenous variable (as explained below) in the empirical model.

Section snippets

Data collection

The data for this analysis were collected through face-to-face interviews with a sample of Italian consumers in charge of their grocery shopping. The survey was undertaken in 2012 in Milan, northern Italy. Consumers were approached at random outside 40 grocery stores, including hypermarkets and supermarkets. Systematic sampling started from the address list of all the grocery stores in the city with respect to the post code, and 26 supermarkets and 14 hypermarkets were selected. Twenty

Results

The results of model A with nutritional knowledge as a dependent variable indicate that females have greater knowledge than males (0.180) and reveal a positive relationship between knowledge and education (Table 2). Moreover, the results suggest that the type of information source used by consumers to obtain food-related information is associated with their knowledge level. In detail, a negative relationship was found between consumers' use of the internet and knowledge level (−0.063), while a

Discussion

The goal of this article was to explore the association between consumers' HO and how often they used nutritional labels. The results indicate that nutritional labels are used more frequently by consumers with high HO compared with those who are less health conscious. These results are consistent with those obtained in previous studies that investigated the relationship between label usage and health practices.38, 39, 40 These studies suggested that when consumers are more health motivated,

Acknowledgements

This study was undertaken within the research project ‘Mobile Service for Agro Food’ (M4A) (http://mose4agrofood.disco.unimib.it). A previous draft of this paper was presented at the 29th International Conference of Agricultural Economists (ICAE)—Agriculture in an interconnected world, 8–14 August 2015, Milan, Italy.

Ethical approval

None sought.

Funding

This project was financed by Lombardy Region administration, contract n. UNIAGI-14167. The information in this document reflects the authors' views alone, and the

References (46)

  • A. Cavaliere et al.

    Nutrition and health claims: who is interested? An analysis of consumer preferences in Italy

    Food Qual Prefer

    (2015)
  • M. Grossman

    Education and nonmarket outcomes

  • K.G. Grunert et al.

    Nutrition knowledge, and use and understanding of nutrition information on food labels among consumers in the UK

    Appetite

    (2010)
  • H. Chang et al.

    Mother's nutritional label use and children's body weight

    Food Policy

    (2011)
  • A. Cavaliere et al.

    Does consumer health-orientation affect the use of nutrition facts panel and claims? An empirical analysis in Italy

    Food Qual Prefer

    (2016)
  • N. Geeroms et al.

    Consumers' health-related motive orientations and ready meal consumption behaviour

    Appetite

    (2008)
  • A. Cavaliere et al.

    Healthy–unhealthy weight and time preference: is there an association? An analysis through a consumer survey

    Appetite

    (2014)
  • M. Bonaccio et al.

    Nutrition knowledge is associated with higher adherence to Mediterranean diet and lower prevalence of obesity. Results from the Moli-sani study

    Appetite

    (2013)
  • G. Dorte et al.

    Government interventions to aid choice: help to self-help or paternalism?

    Health Policy

    (2015)
  • T. Mora et al.

    The influence of obesity and overweight on medical costs: a panel data perspective

    Eur J Health Econ

    (2015)
  • S. Vallagårda

    English obesity policies to govern and not to govern

    Health Policy

    (2015)
  • G. Cowburn et al.

    Consumer understanding and use of nutrition labelling: a systematic review

    Public Health Nutr

    (2005)
  • M.F. Teisl et al.

    Measuring the welfare effects of nutrition information

    Am J Agric Econ

    (2001)
  • Cited by (0)

    View full text