Master’s Thesis
The implementation of a new front-of-package label in
the Netherlands: The Nutri-Score
Effects of the Nutri-Score label on Perceived Healthfulness and Purchase
Intention with moderation of Health Consciousness
Roselot Wierda 12832057 Graduate school of Communication Master’s programme Communication Science
Track: Persuasive Communication Supervisor: Hans Feenstra
Abstract
In 2021, a new front-of-package (FOP) nutrition label called the ‘Nutri-Score’ will be implemented in the Netherlands. This label is part of a national prevention plan and aims to be an aid to healthier lifestyles among the Dutch population. The current study examined for both healthy and unhealthy products (1) the effects of the Nutri-Score label on consumers’ Perceived Healthfulness of products, (2) the effects of the Nutri-Score on consumers’
Purchase Intention and (3) the moderating role of Health Consciousness on those effects. 219 respondents were randomized and exposed to several Dutch snacks. One half of the
respondents were exposed to snacks with the Nutri-Score label and the other half were exposed to snacks without a label. Participants rated their Perceived Healthfulness of the snacks and their Purchase Intention. Furthermore, participants answered questions about their Health Consciousness. Results showed that participants who were exposed to products with the Nutri-Score label perceived healthy snacks as healthier and unhealthy snacks as
unhealthier compared to participants who were exposed to products without label. Moreover, participants had a higher intention to purchase healthy snacks when the Nutri-Score label was present. Furthermore, a moderation effect of Health Consciousness was found. The effect of the Nutri-Score label on consumers’ Perceived Healthfulness of healthy snacks was more positive for high health-conscious people compared to low health-conscious people. These results suggest that the Nutri-Score label caused positive effects for healthy snacks, but little effects were found for unhealthy snacks. Studies examining the effects of the Nutri-Score label on other unhealthy product categories are greatly needed to determine the label effectiveness.
Table of contents
Introduction ... 4
Theoretical Framework ... 6
Method... 13
Results ... 18
Conclusion and Discussion ... 22
References ... 29
Appendix A – Demographics ... 36
Appendix B - Stimuli ... 37
Appendix C – Introduction, Informed Consent and Instruction ... 41
Introduction
The prevalence of overweight Dutch people has increased in recent years, up to 50.1% of the population in 2019 (Zantinge, Van der Wilk, & Jager, 2020). Therefore, this is a serious and growing health problem in the Netherlands which has both social and economic
consequences (Bieleman, Visscher, & Zantinge, 2019). Overweight people are more frequent absent from work and they have a bigger possibility to develop early disability which causes enormous health costs (Crawford, Jeffery, Ball, & Brug, 2011).
Two things that are strongly related to overweight are nutrition and eating patterns (Nicklas, Baranowski, Cullen, & Berenson, 2001; Wendel-Vos, Blokstra, Zwakhals, Wijga, & Tijhuis, 2005). When people consume many unhealthy food products, they have more
possibility to develop bad eating patterns. Supportive environments where people are being encouraged to make healthful nutrition choices, are an important way to make public health better (Van Kleef & Dagevos, 2015). An example of those environments is the supermarket, which plays a big role as interface between consumers and consuming unhealthy food products. Supermarkets have the opportunity to promote healthy eating behaviour of the population, rather than to undermine healthy eating behaviour (Charlton, Käkhönen, Sacks, & Cameron, 2015). However, a lot of supermarkets are guilty of promoting unhealthy eating behaviours that contribute to overweight problems (Charlton et al., 2015).
One way to promote healthy products in the supermarket, is the use of front-of-package (FOP) labelling (Vyth et al., 2010). FOP-labels are simplified nutrition symbols or information on the front of food packages or shelves, visible to the consumer (Hersey, Wohlgenant, Arsenault, Kosa, & Muth, 2013). The labels are considered as an essential tool
FOP-label in 2021: ‘The Nutri-Score’ (de Consumentenbond, 2019). This label is part of a national prevention plan and aims to be an aid to healthier lifestyles among the Dutch population (Ministerie van Volksgezondheid, Welzijn en sport, 2020). In the process of choosing a new food label, most research was done by comparing several food labels (Blokhuis, 2019). When comparing the Score with two other FOP-labels, the Nutri-Score was the most effective (van der Lelij, Röhling, Bot, & Zuiderduin, 2019).
Previous research showed that the presence of a FOP-label increased the perceived healthfulness of healthy products and decreased the perceived healthfulness of less healthful products compared to products without a label (van Herpen, Seiss, & van Trijp, 2012). Furthermore, FOP-labels can affect consumers’ purchase intention. Purchase intention for products with the presence of a label were higher compared to products without a FOP-label (Andrews, Burton, & Kees, 2011). FOP-FOP-labels can both lead to an increase of
purchasing healthy food products and a decrease of purchasing products with a less nutritious value (Wansink & Chandon, 2006; Cawley et al., 2015). However, these effects have not been studied for the Nutri-Score yet.
Individual variables may affect consumers’ processing of nutrition information on product packages (Keller, Landry, Olson, Veliquette, Burton, & Andrews, 1997). For instance health consciousness, which refers to the overall psychological orientation to an individual’s health and awareness of healthiness of their activities and lifestyle (Kaskutas & Greenfield, 1997; Kraft & Goodell, 1993).The more health-conscious a consumer is, the more stimulated he is to look for nutrition information to make a healthier food choice (Visschers, Hess, & Siegrist, 2010). With regard to the Nutri-Score, no evidence about moderating effects of health-consciousness exists.
A lot of studies have compared FOP-label systems in their ability to enhance different variables. However, only a limited number of studies have examined the Nutri-Score. In
addition, studies that have been done in the Netherlands with regard to Dutch products are limited. Therefore, studying the effectiveness of the Nutri-Score in the Netherlands can be very useful. If the Nutri-Score makes it possible to make healthfulness perceptions of products better and to increase purchase intentions of healthy food products rather than unhealthy food products, this may positively affect consumers’ eating patterns. Moreover, since low health-conscious people are not concerned and motivated to improve their health it is useful to determine whether the Nutri-Score label attracts their attention and affects their food choices. This can contribute in realizing healthier lifestyles and preventing the risks of becoming overweight. As a result of that, public health in the Netherlands can improve, as the number of overweight people will decrease. To get more insights in the effectiveness of the Nutri-Score label in the Netherlands, the following research question will be examined in this study:
RQ: What are the effects of the exposure to food products labelled with the Nutri-Score compared to exposure to food products without the Nutri-Score label on consumers’ Perceived Healthfulness and Purchase Intention of these products, and are these effects moderated by consumers’ Health Consciousness?
Theoretical Framework
FOP-label
The use of methods for categorising food products according to their nutritional quality is both feasible and practical and a good step in tackling obesity and improving public
extensively. The use of FOP-labels has been indicated as an effective method to improve consumers ability to find and use nutritional information (Arrúa et al., 2017; Hawley,
Roberto, Bragg, Liu, Schwartz, & Brownell, 2012). FOP-label systems vary in shape, colour, size and the nutrient focus (Kanter, Vanderlee, & Vandevijvere, 2018). Interest in such nutrition information on food packages is widespread, but the degree of interest differs between consumers and is dependent on the consumer himself, the situation and the products (Grunert & Wills, 2007). Consumers like the idea of simplified FOP information, but they do not all like the same format (Grunert & Wills, 2007).
The Nutri-Score
The Nutri-Score as FOP-label was developed by a French Epidemiology Research Team. In 2017, the definitive version was chosen after a test in which different versions of the label were compared (see figure 1; Chantal & Hercberg, 2017). The Nutri-Score is an
interpretive nutrition rating system which provides nutrition information as guidance (Kanter et al., 2018). Products get a summarized nutritional score from A to E based on points that are calculated via a formula based on a scientific algorithm (Hersey et al., 2013). Both bad
nutrients as energy, sugars, saturated fatty acids and salt and good nutrients as proteins, fibre, percentage of fruit, vegetables, nuts, rapeseed oil, walnut oil and olive oil are taken into account. Products get positive points for healthy nutrients and negative points for unhealthy nutrients (de Consumentenbond, 2019). The final amount of points equals one of the 5 letters combined with a colour ranged from green to red to improve readability (see figure 2; Santé Publique France, 2020). A distinction of points and letter combinations is made between solid food and beverages. Products with the healthiest nutritional value will get score A combined with a dark green colour and products with the least healthy nutritional value will get score E combined with a dark red colour.
Figure 1. The Nutri-Score label Figure 2. Points with corresponding Nutri-Score
Relationship FOP-labels and Perceived Healthfulness
The effects of a number of FOP-labels have been studied. Perceived healthfulness is one of the variables that can be affected by FOP-labels (Borgmeier & Westenhoefer, 2009; Hawley et al., 2012). Consumers who have problems with evaluating the healthfulness of a product can use a FOP-label as an effective indicator and signal of product healthfulness (Nathan, Yaktine, Lichtenstein, & Wartella, 2012; Volkova & Mhurchu, 2015). Andrews and colleagues (2011) found that products with the presence of the Smart Choices summary icon (a FOP-label), were overall perceived as healthier than products without a FOP-label. Another study which examined the impact of three different FOP-labels (Signpost logos, Multiple Traffic Light label and Guideline Daily Amount label) on consumers’ perceived healthfulness found that all labels increased healthfulness perceptions of healthful products (Van Herpen et al., 2012). Moreover, two of the labels, the Multiple Traffic Light label and the Guideline Daily Amount label, reduced the perceived healthfulness of less healthful options (Van Herpen et al., 2012). Those results suggest that FOP-labels acted as implicit health claims, from which consumers can make positive inferences.
H1: Consumers exposed to food products labelled with the Nutri-Score will have a more positive Perceived Healthfulness of those products compared to consumers exposed to food products without the Nutri-Score label in such a way that they have a higher Perceived Healthfulness of healthy products and a lower Perceived Healthfulness of unhealthy products.
Relationship FOP-labels and Purchase Intention
Another variable that can be affected by exposure to FOP-labels is Purchase Intention (Hawley et al., 2012). Between one-half and two-thirds of all purchase decisions are made last minute when the point of purchase is there (Inman & Winer, 1998). These point-of-purchase decisions are made in a very short amount of time, while consumers are being exposed to a growing number of stimuli on food packages (Nathan et al., 2012). One of those stimuli that consumers will see at this point are FOP-labels.
Research has shown that nutritional label viewing was related to food purchasing in a way that participants looked longer at labels of foods they decided to purchase compared to foods they did not purchase (Graham & Jeffery, 2012). This indicates a possible effect of food labels on purchase intention. Wansink and Chandon (2006) found that labelling snacks as ‘low fat’ increased food intake during a single consumption by up to fifty percent. This suggests that the intention to purchase healthy products was higher for labelled products (Wansink & Chandon, 2006). For unhealthy products, the opposite effect was found by Cawley and colleagues (2015). They found that the guiding stars system (a FOP-label) led to a decrease in purchasing products with a less nutritious value rather than an increase of purchasing products with a nutritious value among consumers. This finding was supported by research into the Nutri-Score in which labelled products led to significantly lower purchase intentions for fifty percent of the examined unhealthy products which had all a green D as Nutri-Score (Ares et al., 2018). An explanation of the decrease of intention to purchase
unhealthy products is that consumers learn that they have underestimated the content of unhealthy nutrients by using a food label (Zarkin & Anderson, 1992).
Results of previous studies suggest that a FOP-label hold promise to help consumers by purchasing healthier food products and to hold consumers back from purchasing unhealthy food products. Therefore, the following hypothesis was developed:
H2: Consumers exposed to food products labelled with the Nutri-Score will have a more positive Purchase Intention compared to consumers exposed to food products without the Nutri-Score label in such a way that they have a higher Purchase Intention for healthy products and a lower Purchase Intention for unhealthy products.
Moderating effect of Health Consciousness
Moderating effect of Health Consciousness on Perceived Healthfulness. Product
attributes considered as important when making food decisions were studied by Mai and Hoffmann (2012). They found that those attributes, including FOP-labels, are determined by consumers’ level of Health Consciousness. Health-conscious people are more aware of their health and examine attributes that trigger diet-related diseases as obesity carefully (Mai & Hoffmann, 2012). Furthermore, they are concerned about their health and want to strive to enhance and maintain their state of health by engaging in healthy behaviours, among which consuming healthy food products (Mai & Hoffmann, 2012). Moreover, health-conscious people maintain healthier lifestyles, are more active in seeking product information and read food labels more often than less health-conscious people (Kempen, Muller, Symington, &
related attributes such as price and taste (Mai & Hoffmann, 2012).People with high health motivation are stimulated to process nutrition information deeper (Visschers et al., 2010). Pieters and Warlop (1999) confirmed this by showing an increased duration of consumers’ visual attention to products for highly motivated consumers, which implies deeper
information processing.
The assumption that health-conscious people consider a larger set of health-related attributes important is based on the Elaboration Likelihood Model (ELM) (Petty & Cacioppo, 1986). According to the ELM, the level of consciousness influences the elaboration in
information processing. Less conscious people are more likely to base their decisions on simple rules. They process information via a peripheral route, based on heuristic cues. In contrast to that, conscious people engage in a more detailed processing of a product, via a central route in which they consider a larger set of attributes (Mai & Hoffmann, 2012).
To sum up, previous research indicates that health-consciousness can affect the extent to which consumers read and process FOP-labels. Health Consciousness might strengthen the effects of the Nutri-Score label on Perceived Healthfulness of products. To examine this, the following hypothesis was developed:
H3: The effects of exposure to food products labelled with the Nutri-Score on consumers’ Perceived Healthfulness of those products will be more positive for people who have a high level of Health Consciousness compared to consumers who have a low level of Health Consciousness.
Moderating effect of Health Consciousness on Purchase Intention. Magnusson,
Arvola, Hursti, Åberg and Sjödén (2003) found health concerns as a strong predictor of purchase intention for organic foods. This suggests that egoistic motives can work as predictors of the purchase of foods. Hersey and colleagues (2013) confirmed this by
indicating that health-conscious individuals are more likely to purchase foods indicated as ‘healthy’ by front of package labels. Another example of this was found in a research of Vyth and colleagues (2010) where consumers who were more concerned about weight control and product information, purchased more products with the ‘Choices logo’ (a FOP-label). They suggest that health-conscious people buy more food products with a nutrition logo that indicates a food product as healthy (Vyth et al., 2010). Moreover, it was found that health consciousness consumers use nutritional labelling when they make a purchase decision in a way that they switch away from unhealthy products to healthy products (Prathiraja & Ariyawardana, 2003).
The studies mentioned above indicate a possibility of a moderating role of Health-consciousness in such a way that high Health Consciousness might strengthen the effects of the Nutri-Score label on Purchase Intention. Because this will be an interesting addition to the literature, the following hypothesis was developed:
H4: The effects of exposure to food products labelled with the Nutri-Score on
consumers’ Purchase Intention will be more positive for people who have a high level of Health Consciousness compared to consumers who have a low level of Health Consciousness.
The current experiment
The hypotheses in this experiment will be tested separately for healthy and unhealthy food products. A conceptual model of the hypotheses is illustrated in figure 3.
Figure 3. Conceptual model of the research question
Method
Participants
To test the hypotheses in this study, data were collected via an online experiment created with the survey program Qualtrics. Participants were recruited by receiving a link via personal contacting, social media and mail. Dutch adults aged eighteen years and older were eligible to participate. In total, 219 respondents did participate. 130 (59.4 %) of them were female and 89 (40.6 %) of them were male. Most of the respondents were high educated (66.2%), followed by intermediate educated (30.5%) and low educated (3.2%). All the participants had the Dutch nationality. The highest percentage of the participants was aged between 18 and 25 years (42.5%). A complete overview of demographic characteristics of the participants is given in Appendix A.
Design
The experimental design of this study was a between subjects factorial design with two groups. The two groups consisted of the Score label absent (n = 110) and the Nutri-Score label present condition (n = 109). Qualtrics was used to randomly allocate participants
Perceived Healthfulness of a product Purchase Intention Nutri-Score label present vs. absent Health Consciousness high vs. low H1 H2 H3 H4
to one of the conditions. Health Consciousness as moderator was a quasi-experimental factor and divided into two levels: low- or high health-conscious. The level of consciousness was measured during the survey.
Stimuli
The food product category used in this research was snacks, because of the increasing role which snacks play in people becoming overweight and the fact that overweight people consume more snacks than normal-weight people (Papies, Potjes, Keesman, Schwinghammer, & van Koningsbruggen, 2014).
To determine which snacks were often misinterpreted among respondents, ten respondents were exposed to eight Dutch snacks with Nutri-Score A and B and twenty-four Dutch snacks with Nutri-Score D and E. The Nutri-Scores of snacks were obtained through a reliable list of Nutri-Scores released by ‘De Consumentenbond’ (Appendix B, figure 1). Respondents were asked to select five ‘unhealthy’ snacks out of the list of snacks with Nutri-Score A and B and five ‘healthy’ snacks out of the list of snacks with Nutri-Sore D and E. The results showed four healthy snacks which were most frequently seen as unhealthy and four unhealthy snacks which were most frequently seen as healthy. Based on those results a list of four healthy (Nutri-Score A and B) and four unhealthy (Nutri-Score D and E) snacks was drawn and used as stimuli in this study (Appendix B, figure 2).
The products were shown to participants as coloured images. The Nutri-Score label was implemented by using computer artworks, all products with a consistent format and a consistent position of the label on the bottom left. The stimuli used in this study consisted of both snacks labelled with and without the Nutri-Score label (Appendix B, table 1).
Pre-test
A pre-test was conducted to test if the questionnaire was understandable and to gain insights in possible mistakes or uncertainties. Ten people filled out the questionnaire and gave feedback. On substantive level nothing was changed, because all the people did understand the information in the questionnaire. Only some small spelling errors were adapted.
Procedure
When the respondents clicked on the link to the questionnaire, they first saw an introduction in which they were told that the study was about snacks. The introduction also included a privacy and anonymity guarantee. After that, an informed consent was shown to ask if they agreed with the information. Only respondents who agreed, were directed to the next page where they could read the instruction of the questionnaire. The introduction, informed consent and instruction are given in Appendix C. Next, participants were randomly assigned to one of the two conditions of the Nutri-Score label (present/absent). Thereafter, they saw eight pictures of snacks one at a time. For each snack, Perceived Healthfulness and Purchased Intention were measured. After that, Health Consciousness and Brand Familiarity were measured. Next, only in the Nutri-Score label present condition, two manipulation check questions were asked. The questionnaire ended with demographic questions. Finally, the participants were debriefed. An overview of the mentioned questions and the debriefing form is given Appendix D.
Measures
Dependent variable: Perceived Healthfulness. Perceived Healthfulness was
measured on a five-point Likert-Scale by the question: “How healthy is this product to you?” anchored at 1 (not healthy at all) and 5 (very healthy) (Feunekes, Gortemaker, Willems, Lion, & Van Den Kommer, 2008). The differences in means of scores on Perceived Healthfulness between the Nutri-Score label conditions (present/absent) were compared.
Dependent variable: Purchase Intention. Purchase Intention was measured by three
items on a five-point Likert scale anchored at 1 (totally disagree) and 5 (totally agree) (Bialkova, Sasse, & Fenko, 2016). The three statements were introduced by the guiding information “Imagine that you are in the supermarket right now and you must buy a healthy snack.” An example of a statement to measure Purchase Intention is: “The probability that I would consider buying this product is high.” To test if the three items measure the same construct a principal factor analysis was performed. Only one component had an Eigenvalue above 1 (EV = 2.78) and there was a clear point of inflexion after this component in the scree plot. Together, the three factors explained 92.71% of the variance. The reliability of the scale was good, α = .96. Therefore, in further analyses the three items will be taken together to measure Purchase Intention.
Moderator: Health Consciousness. Health Consciousness was measured by five
items on a five-point Likert scale anchored at 1 (totally not agree) and 5 (totally agree) (Kaskutas & Greenfield, 1995). Examples of statements to measure Health Consciousness were: “I am usually not very concerned about what I eat and drink” and “I am very well informed on health matters”. A principal factor analysis showed that the five items measured the same construct. Only one component had an Eigenvalue above 1 (EV = 2.60) and there was a clear point of inflexion after this component in the scree plot. Together, the three factors explained 52.02% of the variance. The reliability of the scale was good, α = .77. Therefore, in further analyses the three items will be taken together to measure Health Consciousness.
health-conscious (M = 4.16, SD = .32). A t-test showed that the two groups did differ significantly t (217) = -17.99, p < .001, 95 % CI [-1.13, -.91].
Control variables. Multiple control variables were included to ensure results were not
affected by possible differences between groups. Age (18-25, 26-35, 36-45, 46-55, 56-65, 66-75, 76-85, 85+), gender (man, woman, different), the highest finished level of education (none, primary education, preparatory vocational secondary education, senior general secondary education, university preparatory education, secondary vocational education, higher professional education , university education bachelor’s degree, university education master’s degree) and nationality (Dutch, other) were measured as demographics via multiple choice questions.
Moreover, a list of brand names of the used stimuli (Bolletje, De Graanschuur, Liga, Nakd, Zonnatura, Hero, Snelle Jelle, Bio Today, None) was shown twice. Respondents were asked to indicate which brands they were familiar with and of which brands they bought snacks sometimes.
Manipulation check. It was checked if the respondents in the manipulation condition
saw the Nutri-Score label. Therefore, participants were asked if they did remember what the label looked like. This was done by the multiple-choice question: “What was shown in the boxes on the label?”. 88.1% of the participants gave the right answer. Based on this, we can assume that most of the participants noticed the Nutri-Score label. It was also checked if the respondents used the label, by showing them a picture of the label and asking, “Did you use this label by making your choices?”. 47,7% of the respondents answered that they used the label by either a part or all of their answers. 42,2% of the respondents answered that they did not use the label and 10,1% of the respondents answered that they did not see the label.
Results
Randomization check
To test if the randomization of participants across the experimental groups was
successful, three Chi-square tests were done. Results showed that the conditions did not differ significantly in terms of Gender χ2 (1) = 1.54, p = .237, Age χ2 (7) = 5.39, p = .612 and Educational level χ2 (2) = 1.47, p = .480. Therefore, we can assume that the participants in the different conditions were equal in terms of Gender, Age and Educational level.
In addition, because existing brands used as stimuli, Brand Familiarity among
respondents in the two conditions was tested. Results showed that the conditions are equal in Brand Familiarity for both healthy snacks t (217) = .25, p = .799, 95 % CI [-.04, .05] and unhealthy snacks t (217) = .57, p = .571, 95 % CI [-.03, .07]. Moreover, respondents were asked if they purchased snacks of the brands before. Results showed for both healthy snacks t (217) = .57, p = .566, 95 % CI [-.05, .10] and unhealthy snacks t (217) = -.52, p = .959, 95 % CI [-.05, .04] that there were no differences between conditions in earlier buying behaviour of products of the brands.
Hypotheses test
To test the hypotheses a multivariate analysis of variance was performed. The dependent variables were Perceived Healthfulness and Purchase Intention of healthy and unhealthy snacks and the independent variables were the Nutri-Score label and Health Consciousness.
Hypothesis 1. Results showed a significant effect for both healthy snacks F (1, 217) =
Score label perceived unhealthy products as unhealthier (M = 2.85, SD = .82) than participants exposed to products without the Nutri-Score label (M = 3.15, SD = .79). Therefore, hypothesis 1 was confirmed.
Hypothesis 2. A significant effect was found for healthy snacks F (1, 217) = 8.52, p =
.004, η2 = .04, but not for unhealthy snacks F (1, 217) =1.76, p = .186, η2 = .01. Participants exposed to healthy products with the Nutri-Score label had a higher intention to purchase the products (M = 2.78, SD = .76) than participants exposed to healthy products without the Nutri-Score label (M = 2.50, SD = .70). The Purchase Intention of participants exposed to unhealthy products with the Nutri-Score label (M = 2.56, SD = .81) was not significantly lower than the Purchase Intention of participants exposed to unhealthy products without the Nutri-Score label (M = 2.71, SD = .84). Therefore, hypothesis 2 was confirmed for healthy snacks and rejected for unhealthy snacks.
Hypothesis 3. For healthy snacks, an significant interaction effect of the Nutri-Score
label and Health Consciousness was found F (1, 215) = 4.91, p = .028, η2 = .02. An
illustration of this interaction effect is given in figure 4. The interaction effect indicates that the effects of exposure to healthy products with the Nutri-Score label are more positive for high health-conscious people who perceived healthy products with the Nutri-Score label significantly as healthier (M = 3.10, SD = .70) compared to healthy products without the Nutri-Score label (M = 2.62, SD = .66). Low health-conscious did not significantly perceived healthy products with the Nutri-Score label as healthier (M = 3.04, SD = .68) compared to healthy products without the Nutri-Score label (M = 2.96, SD = .60). Therefore, hypothesis 3 was confirmed for healthy snacks.
Figure 4. Interaction effect of Health Consciousness and the Nutri-Score label for Perceived Healthfulness of healthy snacks.
For unhealthy snacks, no interaction effect of the Nutri-Score label and Health
Consciousness was found F (1, 215) = .33, p = .564, η2 = .002. High health-conscious people perceived unhealthy products with the Nutri-Score label not significantly as unhealthier (M = 2.66, SD = .78) compared to unhealthy products without label (M = 3.00, SD = .82). Also, Low health-conscious people perceived unhealthy products with the Nutri-Score label not significantly as unhealthier (M = 3.14, SD = .90) compared to unhealthy products without the label (M = 3.36, SD = .72). Therefore, hypothesis 3 was rejected for unhealthy snacks.
Hypothesis 4. Results show that there was no interaction effect of the Nutri-Score
label and Health Consciousness for both healthy snacks F (1, 215) = 2.12, p = .147, η2 = .01 and unhealthy snacks F (1, 215) = .09, p = .769, η2 =.00. With regard to healthy snacks, results showed that for high health-conscious there were no significant differences between
1.0 2.0 3.0 4.0 5.0 A B S E N T P R E S E N T P E R CE IV E D H E A L T H F U L N E S S O F H E A L T H Y S N A K CS
THE NUTRI-SCORE LABEL
I N T E R A C T I O N E F F E C T O F H E A L T H
C O N S C I O U S N E S S A N D T H E N U T R I - S C O R E L A B E L
=.61) the Nutri-Score label.
For unhealthy snacks, results showed that for high health-conscious people there were no significant differences between exposure to unhealthy snacks with (M = 2.42, SD = .81) and without (M = 2.59, SD = .86) the Nutri-Score label. Also, for low health-conscious people there were no significant differences between exposure to unhealthy snacks with (M = 2.77, SD = .78) and without (M = 2.87, SD = .79) the Nutri-Score label. Therefore,
hypothesis 4 was rejected.
To sum up, hypothesis 1 was confirmed for both healthy and unhealthy snacks, hypotheses 2 and 3 were confirmed for only healthy snacks and hypothesis 4 was rejected for both healthy and unhealthy snacks. An overview of the means and standard deviations is given in table 1.
Table 1
Means and Standard Deviations for Perceived Healthfulness and Purchase Intention per level of Health Consciousness and in total
a Mean scores between the Nutri-Score label conditions (present vs. absent) differ significantly at p < .05.
b Mean scores between Health Consciousness conditions (high vs. low) differ significantly at p < .05.
Conclusion and Discussion
The first aim of this study was to examine the effects of exposure to food products labelled with the Nutri-Score compared to exposure to food products without the Nutri-Score label on consumers’ Perceived Healthfulness and Purchase Intention. Hypothesis 1 predicted
Healthy snacks Unhealthy snacks
Nutri-Score label Nutri-Score label
Absent Present Total Absent Present Total Perceived Healthfulness Health Consciousness Low 2.96 (.60) 3.04 (.68) 3.00 (.64) 3.36 (.72) 3.14 (.80) 3.26 (.77) High 2.62 (.66)ab 3.10 (.70)ab 2.87 (.72) 3.00 (.82) 2.66 (.78) 2.82 (.81) Total 2.76 (.66)a 3.08 (.69)a 2.92 (.69) 3.15 (.79)a 2.85 (.82)a 3.00(.82) Purchase Intention Health Consciousness Low 2.69 (.61) 2.81 (.71) 2.74 (.66) 2.87 (.79) 2.77 (.78) 2.82 (.78) High 2.35 (.74) 2.77 (.79) 2.57 (.79) 2.59 (.86) 2.42 (.81) 2.50 (.84) Total 2.50 (.70)a 2.78 (.76)a 2.64 (.74) 2.71 (.84) 2.56 (.81) 2.63 (.83)
Score indeed perceived healthy products as healthier and unhealthy products as unhealthier. These results are in line with previous studies, which found that FOP-labels can increase healthfulness perceptions of healthful products and reduce healthfulness perceptions of less healthful products (Andrews et al., 2011; Van Herpen et al., 2012; Nathan et al., 2012; Volkova & Mhurchu, 2015).
In addition, hypothesis 2 predicted that consumers who are exposed to products with the Nutri-Score label have a higher Purchase Intention for healthy products and a lower Purchase Intention for unhealthy products compared to consumers who are exposed to products without a label. Results of this study have shown that consumers exposed to products labelled with the Nutri-Score have indeed a higher Purchase Intention for healthy products. This is in line with previous studies, which found that labelling healthy products could increase Purchase Intention for these products (Wansink & Chandon, 2006).
Intentions to purchase unhealthy products were not decreased when people were exposed to products with Nutri-Score label. This is not in line with results of previous studies which showed that FOP-labels led to a decrease in purchasing products with a less nutritious value (Ares et al., 2018; Cawley et al., 2015). A Possible explanation for the lack of support with regard to unhealthy snacks, is the idea that perceived unhealthfulness of food can
increase its attractiveness (Raghunathan, Naylor, & Hoyer, 2006). The so called ‘unhealthy is tasty’ intuition can affect choice of food products in a way that Purchase Intentions for unhealthy food increases because consumers intuitively believe the unhealthier the food, the tastier it is (Raghunathan, Naylor, & Hoyer, 2006). This might have caused that despite the Nutri-Score label, purchase intentions for unhealthy products did not decrease.
The second aim of this study was to examine a possible moderation effect of Health Consciousness. Hypothesis 3 predicted that the effects of exposure to food products labelled with the Nutri-Score on consumers’ Perceived Healthfulness of these products are more
positive for people who are high health-conscious compared to consumers who are low health-conscious. The results of this study have supported the hypothesis with regard to healthy products. This is in line with previous research which found that considering FOP-labels as important when making food decisions is determined by a consumer’s level of Health Consciousness (Mai & Hoffman, 2012). Furthermore, the results are in line with previous studies which found that health-conscious people read food labels more often than less health-conscious people (Hersey et al., 2013; Kempen et al., 2012; Mai & Hoffman, 2012). For unhealthy snacks, the hypothesis that the effects would be strengthened was rejected. This finding does not match results of previous studies about more active-seeking of product information of health-conscious people (Hersey et al., 2013; Kempen et al., 2012; Mai & Hoffman, 2012).
Hypothesis 4 predicted a moderating effect of Health Consciousness on Purchase Intention. This hypothesis was rejected for both healthy and unhealthy products. People who are health-conscious were not more inclined to buy healthy food products when those
products were labelled with the Nutri-Score than people who are less health-conscious. This is not in line with results of previous research that suggested that egoistic motives, such as health concerns can work as predictors of purchasing healthy foods (Magnusson et al., 2003). Moreover, support was lacking for the results of previous finding which suggested that health-conscious people are more likely to purchase foods indicated as ‘healthy’ by FOP-labels (Hersey et al., 2013). With regard to unhealthy products, results showed that people who are health-conscious did not have lower intentions to purchase unhealthy food products when those products were labelled with the Nutri-Score than people who are less health-conscious.
A possible explanation for the limited moderating effects of Health Consciousness in hypotheses 3 and 4 are other personal characteristics of health-conscious consumers. Mai and Hoffmann (2012) found that health-conscious individuals who strongly believe in their capability to eat healthily, also known as nutrition self-efficacy, consider more health-related food attributes as important than consumers with low nutrition self-efficacy. Although Health-Consciousness of respondents was measured in this study, it was not measured if health- conscious people also had a high level of nutrition self-efficacy. Moreover, it was found that consumers who are more motivated to process nutrition information are also more sceptical toward health claims (Tan & Tan, 2007). This might have affected the results in this study, in such a way that high health-conscious respondents were sceptical towards the Nutri-Score label and therefore did not use the label. Future research should examine the effects of nutrition self-efficacy, scepticism towards FOP-labels and other possible variables that might have influenced the effectiveness of the Nutri-Score label.
Limitations
The present study has certain limitations which future research could address. First of all, this online experiment is not comparable with a shopping experience in the supermarket. Respondents in this study only saw the front of a package, which is different from a
supermarket visit where consumers can hold and compare products. Answering questions in an online questionnaire entails no other distractions that might occur in actual supermarkets like music and the presence of other shoppers. To test if the impact of the label is different in physical environments, future research should examine the question in this study in an actual supermarket.
The stimuli used in this study were snacks of existing brands. Most respondents were familiar with a major part of the eight brands. In addition to that, some people answered that they bought snacks of some of the brands before. This might have caused biased respondents,
who based their answers on their attitude toward the brand. This could have influenced results in a way that if their attitude toward the brand was positive, their answers were more positive too. A negative brand attitude could have influenced results in the opposite way.
Recommended for future research would be to measure brand attitude to see if positive or negative attitudes might have affected the results.
Additionally, this study is limited to one product category: snacks. The
generalizability of the findings to other food product categories is not that high. Results for other food categories might be different, which is interesting to examine in future research. Moreover, only healthy and unhealthy snacks were examined in this study. Moderate snacks labelled with Nutri-Score C were left behind. Future research is needed to study the effects of the Nutri-Score label on those snacks.
Based on the manipulation check question, it can be concluded that almost all the respondents noticed the Nutri-Score. However, only 47.7% of the respondents said that they have used the label in making their choices. This percentage indicates that a lot of respondents have not used the label by determining the healthfulness of products and by making purchase choices. However, the answer to this question was self-reported. Therefore, there is the possibility that people unconsciously used the label and were not aware of this. To gain more insights in the actual use of FOP-labels, future research should examine this by using eye tracking methods.
Although there was no manipulation in the control condition, it should have been checked if there was a difference between the two conditions in noticing the Nutri-Score label. Therefore, the design of the manipulation check in this research is limited. Only
manipulation check questions. If this had been done, the conviction of the manipulation would have been stronger.
The last limitation of this study is the accuracy of healthfulness perceptions of
products among the respondents. Remarkably, the average score in both the Nutri-Score label absent and present condition on Perceived Healthfulness of healthy snacks was much lower than the actual healthfulness of the snacks. Moreover, the average score on Perceived Healthfulness of unhealthy snacks was much higher than they actually were. This indicates that even if products are labelled with the Nutri-Score, the accuracy of the average score on Perceived Healthfulness is not that high. Future research should study those differences between perceived healthfulness and actual healthfulness of products, to determine if the accuracy of perceived healthfulness of products is affected by FOP-labels.
Despite the mentioned limitations, the results of this study contribute to the existing literature about the effectiveness of FOP-labels. Little research has examined the effectiveness of the Nutri-Score in the Netherlands. This study has found that exposure to products with the Nutri-Score affects consumers’ perceptions of healthfulness in a positive way. Moreover, Purchase Intention for healthy snacks was affected in a positive way. Holding back consumers from purchasing unhealthy snacks is not a result of the implementation of the Nutri-Score label. Furthermore, this study investigated health-consciousness as moderator in the effectiveness of the Nutri-Score label. Results show that the Nutri-Score label is more
effective for health-conscious people compared to low health-conscious people with regard to healthfulness perceptions of healthy products. The effectiveness of the Nutri-Score label on Purchase Intention is not greater for high conscious people compared to low health-conscious people.
Overall, results showed that the label positively affects results for healthy snacks more than for unhealthy snacks. Therefore, it would be recommended to do more research into the
effectiveness of the Nutri-Score label for unhealthy products. By doing this, it can be further examined whether the implementation of the Nutri-Score will be effective. If the effectiveness of a new implemented label in the Netherlands is optimal and it affects perceptions of
healthfulness and purchase intentions in a positive way for both high and low
health-conscious people, there will be a greater possibility of healthier food consumption. As a result of that, public health in the Netherlands can be improved. The choice of a functional label, as tool of the start of making a difference, is therefore very important.
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Appendix A – Demographics
Table 1
Demographic characteristics (gender, age and educational level) of participants in numbers and percentages
Control Manipulation Total
n % n % n % Gender Men 49 44.5 40 36.7 89 40.6 Women 61 55.5 69 63.3 130 59.4 Age 18-25 44 40.0 49 45 93 42.5 26-35 17 15.5 13 11.9 30 13.7 36-45 1 .9 4 3.7 5 2.3 46-55 21 19.1 17 15.6 38 17.4 56-65 22 20.0 17 15.6 39 17.8 66-75 4 3.6 6 5.5 10 4.6 76-85 1 0.9 2 1.8 3 1.4 85+ 0 0 1 0.9 1 0.5 Educational level Low educated 2 1.8 5 4.6 7 3.2 Intermediate educated 33 30 34 31.2 67 30.5 High educated 75 68.2 70 64.2 145 66.2
Appendix B - Stimuli
Figure 1. List of fifty Dutch snacks with corresponding Nutri-Score (De Consumentenbond, 2019)
Figure 2. List of eight selected snacks with corresponding Nutri-Score used as stimuli Nutri-Score Healthy
Snelle Jelle zero A
Bolletje Goed bezig! Havermout naturel B
Liga evergreen krenten B
Nàkd. Cocoa delight fruit & notenreep B
Unhealthy
De Graanschuur granola biscuits rozijnen pompoenpitten D Hero Good ’n Go sunflower seeds, hazelnut, almonds & chia D
BioToday Sesamreep D
Table 1
Snacks labelled with and without the Nutri-Score label
Appendix C – Introduction, Informed Consent and Instruction
Introduction
Beste deelnemer,
Bij deze nodig ik u graag uit om deel te nemen aan een onderzoek dat wordt uitgevoerd onder toezicht van de Graduate School of Communication, onderdeel van de Universiteit van Amsterdam.
Het onderzoek waar u gevraagd wordt aan deel te nemen is onderdeel van mijn Master Thesis. In de vragenlijst krijgt u acht afbeeldingen van tussendoortjes te zien waarvan u inschat hoe gezond ze zijn en aangeeft wat uw koopintentie is. Vervolgens worden enkele vragen over uw bewustzijn van uw gezondheid gesteld.
Het invullen van deze vragenlijst duurt ongeveer vijf minuten.U kunt zo lang over de vragenlijst doen als gewenst. Er zijn geen foute antwoorden, het gaat om uw persoonlijke visie.
Aangezien dit onderzoek wordt uitgevoerd onder verantwoordelijkheid van de Amsterdam School of Communication Research (ASCoR), Universiteit van Amsterdam, worden de volgende zaken gegarandeerd:
1. Uw anonimiteit wordt gewaarborgd en uw persoonlijke gegevens worden onder geen enkele voorwaarde aan derden doorgegeven.
3. Deelnemen aan het onderzoek houdt niet in dat u wordt blootgesteld aan een merkbaar risico of ongemak. U zult niet opzettelijk worden misleid en u zult niet worden blootgesteld aan expliciet aanstootgevend materiaal.
4. Uiterlijk vijf maanden na afsluiting van het onderzoek, kunt u inzage krijgen in een onderzoeksrapport waarin de algemene resultaten van het onderzoek worden toegelicht.
Voor meer informatie over het onderzoek en de uitnodiging om hieraan deel te nemen, kunt u te allen tijde contact opnemen met mij, Roselot Wierda (roselotw@hotmail.com).
Mocht u klachten of opmerkingen hebben over het verloop van het onderzoek en de
procedures die het heeft als gevolg van uw deelname aan dit onderzoek, dan kunt u contact opnemen met het aangewezen lid van de Ethische Commissie dat de ASCoR
vertegenwoordigt op het volgende adres: ASCoR Secretariat, Ethics Committee, University of Amsterdam, Postbus 15793, 1001 NG Amsterdam; 020‐525 3680; ascor‐secr‐fmg@uva.nl. Eventuele klachten of opmerkingen worden strikt vertrouwelijk behandeld.
Ik hoop dat ik u voldoende informatie heb gegeven. Ik wil graag van deze gelegenheid gebruik maken om u bij voorbaat te bedanken voor uw hulp bij dit onderzoek, wat ik zeer op prijs stel.
Met vriendelijke groet,
Informed consent
Voorwaarden en toestemming
• Ik verklaar hierbij dat ik op een duidelijke manier ben geïnformeerd over de aard en werkwijze van het onderzoek, zoals beschreven in de uitnodiging van dit onderzoek.
• Ik ga ermee akkoord, volledig en vrijwillig, deel te nemen aan dit onderzoek. Hiermee behoud ik het recht om mijn toestemming in te trekken, zonder opgaaf van reden. Ik ben me ervan bewust dat ik deelname aan het onderzoek elk moment kan stopzetten.
• Als de onderzoeksresultaten worden gebruikt in wetenschappelijke publicaties of op een andere manier openbaar gemaakt wordt, gebeurt dit op een manier waarbij anonimiteit volledig wordt gewaarborgd. Persoonlijke gegevens worden zonder mijn nadrukkelijke toestemming niet aan derden doorgegeven.
• Als ik nu of in de toekomst meer informatie over het onderzoek wil ontvangen, kan ik via e-mail contact opnemen met Roselot Wierda.
• Als ik klachten heb over dit onderzoek, kan ik contact opnemen met het aangewezen lid van de Ethische Commissie dat de ASCoR vertegenwoordigt, op het volgende adres: ASCoR-secretariaat, Ethische Commissie, Universiteit van Amsterdam, Postbus 15793, 1001 NG Amsterdam; 020-525 3680; ascor‐secr‐fmg@uva.nl.
Ik begrijp de tekst hierboven en ik ga akkoord om deel te nemen aan dit onderzoek: o Akkoord
o Niet akkoord
Ik bevestig hierbij dat ik 18 jaar of ouder ben o Ja
o Nee
Instruction Instructies
• U krijgt na het klikken op de knop rechtsonder (oranje pijl), in totaal acht afbeeldingen van verschillende tussendoortjes te zien.
• Voor elk tussendoortje beantwoordt u vier vragen over uw inschatting van hoe gezond het tussendoortje is en uw intentie om het te kopen.
• Vervolgens worden er vijf vragen over uw bewustzijn van uw gezondheid gesteld en tot slot volgen er een aantal algemene vragen.
• Het invullen van de vragenlijst duurt ongeveer vijf minuten.
Let bij het maken van de vragen op het volgende:
• U kunt per vraag slechts 1 antwoord kiezen.
• De hoeveelheden in de verpakkingen (bijv. meer dan 1 reep in een verpakking) hoeft
u niet mee te nemen in uw beslissing. U kunt uw antwoorden baseren op één tussendoortje uit een verpakking.
Appendix D – Questions and debriefing form
Perceived Healthfulness
Hoe gezond vindt u dit product?
Purchase Intention
Stelt u zich nu voor dat u in de supermarkt staat en een gezond tussendoortje moet kopen. Beantwoord met die gedachte de volgende vragen.
Geef aan in hoeverre u het eens bent met de stelling. Per stelling is er één antwoord mogelijk. Helemaal
niet mee eens
Niet mee
eens Neutraal Mee eens
Helemaal mee eens De kans dat ik zou
overwegen om dit tussendoortje te kopen is
groot als ik op zoek ben naar een gezond
tussendoortje.
o o o o o
Ik zou dit tussendoortje aanraden aan mijn vrienden als zij op zoek
zijn naar een gezond tussendoortje.
o o o o o
De waarschijnlijkheid dat ik dit tussendoortje zou kopen is hoog als ik op zoek ben naar een gezond
tussendoortje. o o o o o Helemaal niet gezond Niet
gezond Neutraal Gezond
Heel gezond
Health Consciousness
Er volgen nu vijf stellingen over uw bewustzijn van uw gezondheid.
Geef aan in hoeverre u het eens ben met de stelling. Per stelling is er één antwoord mogelijk.
Helemaal niet mee
eens
Niet mee
eens Neutraal Mee eens
Helemaal mee eens 1. Ik maak mij meestal
niet veel zorgen over wat
ik eet en drink. o o o o o
2. Ik ben erg goed op de hoogte van
gezondheidskwesties. o o o o o
3. Ik besteed meestal niet veel aandacht aan wat ik eet en drink, zolang het
maar goed smaakt.
o o o o o
4. Ik eet de juiste dingen
zodat ik gezond blijf. o o o o o
5. Alle informatie die tegenwoordig beschikbaar is over voeding interesseert
mij niet.
Brand Familiarity
Kruis aan welke merken uit de lijst hieronder u kent. U kunt meerdere antwoorden aanvinken. Ik ken de volgende merken:
o Bolletje o De Graanschuur o Liga o Nakd o Zonnatura o Hero o Snelle Jelle o Bio Today
o Geen van bovenstaande merken
Kruis aan van welke merken uit de lijst hieronder u wel eens tussendoortjes koopt. U kunt meerdere antwoorden aanvinken.
Ik koop wel eens tussendoortjes van de volgende merken:
o Bolletje o De Graanschuur o Liga o Nakd o Zonnatura o Hero o Snelle Jelle o Bio Today
Manipulation check
Op de acht tussendoortjes waar u zojuist vragen over heeft beantwoord, stond een label. Dit label bevatte 5 vakjes van groen naar rood. Wat stond er in deze vakjes?
o A, B, C, D, E o 1, 2, 3, 4, 5
o Er stond niets in de hokjes
Heeft u bovenstaand label gebruikt bij het maken van uw keuzes?
o Ja, ik heb al mijn keuzes gemaakt met behulp van het bovenstaande label
o Ja, ik heb sommige van mijn keuzes gemaakt met behulp van bovenstaand label o Nee, ik heb mijn keuzes niet gemaakt met behulp van het bovenstaande label o Nee, ik heb bovenstaand label niet gezien
Demographic questions
Wat is uw geslacht? o Man
o Vrouw o Anders
Tot welke leeftijdscategorie behoort u? o 18-25 jaar o 26-35 jaar o 36-45 jaar o 46-55 jaar o 56-65 jaar o 66-75 jaar o 76-85 jaar o 85 + jaar
Wat is het hoogst behaalde onderwijsniveau waarvoor u een diploma heeft behaald? o Geen o Basisschool o VMBO o HAVO o VWO o MBO o HBO o WO bachelor o WO master
Wat is uw nationaliteit? o Nederlandse
o Anders, namelijk: ________________________________________________
Debriefing form
Vergeet niet op de pijl rechtsonder te klikken om uw antwoorden in te sturen!
Dit is het einde van deze vragenlijst. Hartelijk bedankt voor uw deelname.
Het doel van dit onderzoek is om de effectiviteit van een label, de Nutri-Score, te testen. U heeft óf bestaande tussendoortjes met Nutri-Score label gezien, óf bestaande tussendoortjes zonder Nutri-Score label gezien. Op die manier zal blijken wat het effect is van
de aanwezigheid het Nutri-Score label.
Wanneer u tussendoortjes met label heeft gezien, zijn dit niet de verpakkingen zoals ze op dit moment in de supermarkt liggen. Nadat de Nutri-Score in Nederland is ingevoerd (geschat in 2021) zal dit er soortgelijk uit komen te zien.
Met vriendelijke groet, Roselot Wierda
