Evaluation of front-of-pack labeling’s impact on unhealthy food consumption in Israeli households

Abstract Background In 2020, Israel introduced front-of-pack labeling (FOPL), marking unhealthy foods high in sugar/salt/saturated fat in red and Mediterranean diet-conforming foods in green, aiming to facilitate healthy choices through clear nutrition information. Methods Two cross-sectional telephone surveys assessed food purchasing, red/green food consumption frequency, label exposure, and perceived impact before labeling (944 households, 2019) and 3 years post-implementation (500 households, 2023). Results Over 90% of respondents in 2023 reported seeing red labels on packages. Nearly 70% checked for red labels when shopping, vs. only 48% who examined the full Nutrition Facts panel on the back of the package. 60% reported preferring unlabeled alternatives within unhealthy categories. Although 50% reported that compared to the period before the labeling, they purchased fewer red-labeled products, a significant decrease in purchasing rates between timepoints was found only for 2 out of 11 unhealthy food categories-sugary drinks (which during 2022 were also taxed by sugar content) and salty snacks. At both timepoints, rates of purchasing and consumption frequency of unhealthy foods were higher among households with children, compared to other households. Multivariate analysis showed that having children under 18, lower education and bigger household size predicted a higher overall unhealthy consumption score. Red label checking was associated with better scores. Conclusions FOPL raised awareness and shows potential for reducing unhealthy consumption, especially when combined with policies like sugar taxation. Their impact on reducing purchases of nutritionally valueless foods (snacks/sugary drinks) is highly valuable. However, red-labeled food consumption remained high among households with children, a strong predictor of higher unhealthy consumption scores. Continued label promotion, child-targeted interventions, and product reformulation incentives are recommended. Key messages • FOPL shows potential of enhancing healthy choices especially when combined with supportive policies. • Results regarding households with children highlight the need for continued promotion, child-targeted interventions, and product reformulation incentives for impacting long-term habits.