Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019–2020 Texas School Physical Activity and Nutrition Survey
Background: Nutrition labels are a tool to inform and encourage the public to make healthier food choices, but little information is available about use in multi-ethnic adolescent populations in the U.S. The purpose of this study was to examine associations between the level of nutrition label usage...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/16/2/311 |
| _version_ | 1797339481645252608 |
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| author | Christopher D. Pfledderer Nalini Ranjit Adriana Pérez Raja I. Malkani Augusto César Ferreira De Moraes Ethan T. Hunt Carolyn L. Smith Deanna M. Hoelscher |
| author_facet | Christopher D. Pfledderer Nalini Ranjit Adriana Pérez Raja I. Malkani Augusto César Ferreira De Moraes Ethan T. Hunt Carolyn L. Smith Deanna M. Hoelscher |
| author_sort | Christopher D. Pfledderer |
| collection | DOAJ |
| description | Background: Nutrition labels are a tool to inform and encourage the public to make healthier food choices, but little information is available about use in multi-ethnic adolescent populations in the U.S. The purpose of this study was to examine associations between the level of nutrition label usage and healthy/unhealthy eating behaviors among a statewide representative sample of 8th and 11th-grade students in Texas. Methods: We analyzed cross-sectional associations between the Nutrition Facts label use and eating behaviors from a statewide sample of 8th and 11th-grade students in Texas, (<i>n</i> = 4730, weighted <i>n</i> = 710,731, mean age = 14.7 ± 1.6 years; 49% female, 51% Hispanic), who completed the 2019–2020 Texas School Physical Activity and Nutrition (TX SPAN) survey. Students self-reported their level of nutrition label usage to make food choices (5-point Likert scale from “Never” to “Always”) and previous day consumption of 26 food items (13 healthy, 13 unhealthy). The 26 food items were used to calculate a Healthy Eating Index (HEI) score (0–100), a Healthy Foods Index (HFI) score (0–100), and an Unhealthy Foods Index (UFI) score (0–100). Weighted linear regression models were employed to examine the associations between self-reported use of nutrition labels to make food choices and HEI, HFI, and UFI scores. Marginal predicted means of HEI, HFI, and UFI scores were calculated post hoc from linear regression models. The odds of consuming specific individual food items for nutrition label usage were also calculated from weighted logistic regression models. All linear and logistic regression models were adjusted for grade, sex, Body Mass Index (BMI), race/ethnicity, economic disadvantage, and percentage of English language learners by school. Results: A total of 11.0% of students reported always/almost always using nutrition labels to make food choices, 27.9% reported sometimes using them, while 61.0% indicated they never/almost never used nutrition labels to make food choices. The average HEI score among students in the sample was 47.7 ± 5.9. Nutrition Facts label usage was significantly and positively associated with HEI (b = 5.79, 95%CI: 4.45, 7.12) and HFI (b = 7.28, 95%CI:4.48, 10.07), and significantly and negatively associated with UFI (b = −4.30, 95%CI: −6.25, −2.34). A dose–response relationship was observed between nutrition label usage and HEI, HFI, and UFI scores, such that the strength of these associations increased with each one-point increase in nutrition label usage. Students who reported using nutrition labels always/almost always to make food choices had significantly higher odds of consuming healthy foods including baked meat, nuts, brown bread, vegetables, whole fruit, and yogurt (OR<sub>range</sub> = 1.31–3.07), and significantly lower odds of consuming unhealthy foods including chips, cake, candy, and soda (OR<sub>range</sub> = 0.48–0.68) compared to students who reported never/almost never using the Nutrition Facts label. Conclusions: Using the Nutrition Facts labels to make food choices is beneficially associated with healthy and unhealthy eating among 8th and 11th-grade students, although the proportion of students using nutrition labels to make their food choices was low. Public health efforts should be made to improve nutrition literacy and encourage nutrition label use among secondary students in the United States. |
| first_indexed | 2024-03-08T09:48:45Z |
| format | Article |
| id | doaj.art-6cd39a7c84dc45e0865a70df0fc317ac |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-08T09:48:45Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-6cd39a7c84dc45e0865a70df0fc317ac2024-01-29T14:10:23ZengMDPI AGNutrients2072-66432024-01-0116231110.3390/nu16020311Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019–2020 Texas School Physical Activity and Nutrition SurveyChristopher D. Pfledderer0Nalini Ranjit1Adriana Pérez2Raja I. Malkani3Augusto César Ferreira De Moraes4Ethan T. Hunt5Carolyn L. Smith6Deanna M. Hoelscher7Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USADepartment of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USAMichael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USAMichael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USADepartment of Epidemiology, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USADepartment of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USAMichael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USADepartment of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701, USABackground: Nutrition labels are a tool to inform and encourage the public to make healthier food choices, but little information is available about use in multi-ethnic adolescent populations in the U.S. The purpose of this study was to examine associations between the level of nutrition label usage and healthy/unhealthy eating behaviors among a statewide representative sample of 8th and 11th-grade students in Texas. Methods: We analyzed cross-sectional associations between the Nutrition Facts label use and eating behaviors from a statewide sample of 8th and 11th-grade students in Texas, (<i>n</i> = 4730, weighted <i>n</i> = 710,731, mean age = 14.7 ± 1.6 years; 49% female, 51% Hispanic), who completed the 2019–2020 Texas School Physical Activity and Nutrition (TX SPAN) survey. Students self-reported their level of nutrition label usage to make food choices (5-point Likert scale from “Never” to “Always”) and previous day consumption of 26 food items (13 healthy, 13 unhealthy). The 26 food items were used to calculate a Healthy Eating Index (HEI) score (0–100), a Healthy Foods Index (HFI) score (0–100), and an Unhealthy Foods Index (UFI) score (0–100). Weighted linear regression models were employed to examine the associations between self-reported use of nutrition labels to make food choices and HEI, HFI, and UFI scores. Marginal predicted means of HEI, HFI, and UFI scores were calculated post hoc from linear regression models. The odds of consuming specific individual food items for nutrition label usage were also calculated from weighted logistic regression models. All linear and logistic regression models were adjusted for grade, sex, Body Mass Index (BMI), race/ethnicity, economic disadvantage, and percentage of English language learners by school. Results: A total of 11.0% of students reported always/almost always using nutrition labels to make food choices, 27.9% reported sometimes using them, while 61.0% indicated they never/almost never used nutrition labels to make food choices. The average HEI score among students in the sample was 47.7 ± 5.9. Nutrition Facts label usage was significantly and positively associated with HEI (b = 5.79, 95%CI: 4.45, 7.12) and HFI (b = 7.28, 95%CI:4.48, 10.07), and significantly and negatively associated with UFI (b = −4.30, 95%CI: −6.25, −2.34). A dose–response relationship was observed between nutrition label usage and HEI, HFI, and UFI scores, such that the strength of these associations increased with each one-point increase in nutrition label usage. Students who reported using nutrition labels always/almost always to make food choices had significantly higher odds of consuming healthy foods including baked meat, nuts, brown bread, vegetables, whole fruit, and yogurt (OR<sub>range</sub> = 1.31–3.07), and significantly lower odds of consuming unhealthy foods including chips, cake, candy, and soda (OR<sub>range</sub> = 0.48–0.68) compared to students who reported never/almost never using the Nutrition Facts label. Conclusions: Using the Nutrition Facts labels to make food choices is beneficially associated with healthy and unhealthy eating among 8th and 11th-grade students, although the proportion of students using nutrition labels to make their food choices was low. Public health efforts should be made to improve nutrition literacy and encourage nutrition label use among secondary students in the United States.https://www.mdpi.com/2072-6643/16/2/311nutritionnutrition factsfood labelshealthy usingeatingadolescentsTexas SPAN |
| spellingShingle | Christopher D. Pfledderer Nalini Ranjit Adriana Pérez Raja I. Malkani Augusto César Ferreira De Moraes Ethan T. Hunt Carolyn L. Smith Deanna M. Hoelscher Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019–2020 Texas School Physical Activity and Nutrition Survey Nutrients nutrition nutrition facts food labels healthy usingeating adolescents Texas SPAN |
| title | Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019–2020 Texas School Physical Activity and Nutrition Survey |
| title_full | Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019–2020 Texas School Physical Activity and Nutrition Survey |
| title_fullStr | Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019–2020 Texas School Physical Activity and Nutrition Survey |
| title_full_unstemmed | Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019–2020 Texas School Physical Activity and Nutrition Survey |
| title_short | Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019–2020 Texas School Physical Activity and Nutrition Survey |
| title_sort | using the nutrition facts label to make food choices is associated with healthier eating among 8th and 11th grade students an analysis of statewide representative data from the 2019 2020 texas school physical activity and nutrition survey |
| topic | nutrition nutrition facts food labels healthy usingeating adolescents Texas SPAN |
| url | https://www.mdpi.com/2072-6643/16/2/311 |
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