Could warning images on products deter childhood obesity?

A study finds that parents are less likely to buy sugary drinks when they have warnings about health on their labels – reducing sugary drink purchases by 17%

The study, conducted in a realistic setting – a “mini mart” laboratory, demonstrated that parents are less likely to purchase sugary drinks with pictorial health warnings on them, such as juice and soda.

As the first to examine whether pictorial health warnings on sugary drinks, like juice and soda, influence which beverages parents buy for their children, the findings of the study proved that this method of preventing sugary purchases worked, as the warnings reduced parental purchases of sugary drinks for their kids by 17%.

By setting up a study space to mimic a convenience store shopping experience, their positive findings about the effects of image-based warning labels highlight a possible approach to combatting the global struggle with obesity.

Too many children globally, especially in the United States, drink more than the recommended amount of sugary drinks, increasing their risk for obesity and diet-related chronic diseases.

Disparities in obesity by race is factor of targeted marketing

Disparities by race and ethnicity also exist within the demographics of children with obesity. The authors note that there are higher rates of sugary drink consumption and obesity among Black and Latino children compared to non-Latino white children. This, in part, can be appointed to structural factors like targeted marketing.

Published in the journal PLOS Medicine, researchers at the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health ran the study in the “UNC Mini Mart”, displaying drinks with warning labels and taxes on sugary drinks and food – a tactic inspired by the warnings on tobacco and food labels seen in other countries like Chile, Mexico and South Africa.

The researchers applied their former knowledge the impact of warnings on tobacco and food as well as effectiveness of obesity prevention policies in their study. Using 326 parents (25% Black, 20% Latino) of children ages 2 to 12 years old, the randomised trial had:

1. A pictorial warning arm (where drink labels had images representing heart damage and Type 2 diabetes)
2. A control arm (in which drinks labels displayed a barcode)

Participants were told to choose one drink and one snack for their child, along with one household good (this shopping list was designed to conceal the purpose of the study). After shopping, participants completed a survey about their selections and left with their drink of choice and a cash incentive.

Senior author Lindsey Smith Taillie, PhD, said: “We created this store because we saw a major need for research that tests the impact of policies in an food store setting that is much more realistic. When people make choices about what food to buy, they are juggling dozens of factors like taste, cost, and advertising and are looking at many products at once.

“Showing that warnings can cut through the noise of everything else that’s happening in a food store is powerful evidence that they would help reduce sugary drink purchases in the real world.”

Type 2 diabetes and heart conditions can be induced by poor dietary choices

A 17% reduction in purchases of sugary drinks was brought on by using the pictorial warnings on the products, as well as around 45% of parents in the control arm buying a sugary drink for their child compared to 28% in the pictorial warning arm.

Additionally, the researchers used warnings that reduced calories purchased from sugary drinks – this led to parents feeling more in control of healthy eating decisions and thinking more about the potential risks of sugary drinks.

The picture warnings had similar benefits according to parent characteristics, including race, ethnicity, and socioeconomic status, suggesting picture warnings could work equally well across diverse populations.

Lead author Marissa G. Hall, PhD stated: “We think the paper could be useful for policymakers in the U.S. and globally. This evidence supports strong, front-of-package warnings to reduce sugary drink consumption in children.”

The authors highlight that they want to conduct larger studies to analyse the success of the warnings for groups at highest risk of diet-related disease.