An RCT of Front-Of-Package Nutrition Labels in Latino Populations in the U.S.

Abstract

The effects of front-of-package nutrition labels among Latino adults in the U.S., including those with limited English proficiency, remains largely unknown. The Food and Drug Administration has considered a high-in label stating when foods are high in nutrients of concern, but the design differs from Latin American high-in labels in several ways. This study examined the impact of Food and Drug Administration-style high-in labels among Latino consumers. This was an online randomized trial conducted in 2024. A total of 3,053 Latino U.S. adults (49% with limited English proficiency). Participants viewed 1 of 3 labels: numerical labels displaying numerical information about added sugar, saturated fat, and sodium; text high-in labels; and icon high-in labels identical to the text labels plus a magnifying glass icon. Participants viewed 3 frozen pies, 3 frozen pizzas, and 3 frozen meals displaying randomly assigned labels and identified the healthiest and least healthy product within each group (on the basis of nutrient content). Analyses were conducted in 2025. Text high-in labels (49% correct) led to higher correct identification of the least healthy foods than the numerical labels (44%, p<0.001), but the icon high-in labels did not (47%, p=0.07). Neither the text high-in labels (46% correct) nor the icon high-in labels (46%) led to better identification of the healthiest food than the numerical labels (45%, all p≥0.71). Neither high-in label led to more correct identification of foods high in nutrients of concern or higher selection of the healthiest food for purchase than the numerical labels (all p≥0.09). English proficiency moderated the impact of label type on correct identification of the least healthy food (p-interaction=0.003), such that the benefit of high-in labels was only present for participants with high English proficiency. High-in labels helped Latino consumers to identify unhealthy foods more than numerical labels but only among those with high English proficiency. NCT06293963.