The impact of front-of-pack nutrition claims on urban Nepali consumers' food choice processes

Abstract

Background. Obesity is a growing health problem worldwide among children and adults, including in many low and middle income countries which are undergoing a nutrition transition. One such country is Nepal, with the highest prevalence of obesity occurring in urban regions and among people of higher socio-economic status (SES). Past research on nutrition transition suggests that an obesogenic food environment contributes to this problem. One aspect of food choice is the influence of marketing on food packaging, including front-of-package nutrition claims (FOP NCs). FOP NCs on food can be both beneficial and confusing for consumers. In one sense, FOP NCs can help consumers more easily identify healthful foods. However, heuristic processing may lead consumers to unduly attribute overall healthfulness to unhealthful food products bearing a FOP NC. Measuring the effects of FOP NCs is challenging because people are poor at judging the impact of environmental cues (e.g., product packaging) on their attitudes and behavior, and consumer factors specific to urban Nepalis may moderate the influence of FOP NCs. Objective. This study specifically addressed the following research questions: What effects do FOP NCs have on consumers’ purchase intentions and attitudes towards food products, specifically healthfulness, appeal, tastiness, quality of manufacturing, and naturalness of ingredients? How might consumer factors moderate these effects? How do Nepali consumers perceive the trustworthiness and influence of FOP NCs, and what do they report to be their top shopping priorities? Design. This study utilized a convergent parallel mixed-methods design. An experimental field survey was conducted in two phases. The first phase of this survey measured the impacts of FOP NCs on Nepali consumers’ purchase intentions and attitudes towards food products without overtly drawing their attention to the FOP NCs. The second phase measured participants’ receptivity by asking them to describe their attitudes towards one FOP NC, and their shopping priorities, broadly speaking. Participants/setting. Participants were 239 adult shoppers in the Nepali capital Kathmandu (Mage = 32.89; SD = 11.07). Fifty nine percent were women, 43% reported having one child or more age 12 or younger. Participants were recruited as they exited one of three locations of a high-income country-style grocery store (i.e., Bhat Bhateni). Main outcome measures. Participants responded to food product images by rating their purchase intention and seven product attitudes on a 7-point Likert scale. They were also asked to rate one FOP NC on trustworthiness and influence, and then were asked to explain their rating. Finally, they were asked to report their two most important shopping priorities. Results. Regression analyses showed that FOP NCs had inconsistent influence on product attitudes and purchase intention. Consumer factors did not moderate this relationship. Thematic analysis of open-ended questions found various reasons for trust and skepticism in FOP NCs. FOP NCs were largely described as useful, in spite of their lack of influence on decision-making processes in an externally valid test. Nearly 90% of reported shopping priorities did not appear to motivate the use of FOP NCs. Conclusions. FOP NC labels did not show a strong or consistent influence on urban Nepali consumers. Therefore, FOP NCs are not likely to be a strong contributor to the nutrition transition that has been occurring in Nepal during recent years. Other influences on dietary decision-making across the life-course should be investigated.