Effects of a Combined Front-of-Pack Nutrition Label and Nutrition Education Intervention on Healthier Choices of Freshly Prepared Beverages: An Online Randomized Controlled Trial

Freshly prepared beverages are widely consumed in China, yet limited nutrition disclosure may hinder healthier choices. This study evaluated whether front-of-pack (FOP) nutrition labels combined with nutrition education improved stated purchase decisions and healthfulness evaluations for freshly prepared beverages beyond labels alone. Participants (n = 1100) were assigned to a combined intervention group (n = 551) or label-only group (n = 549) and completed six paired beverage tasks before and after intervention. Analyses used continuity-corrected McNemar tests, between-group net effects, transition analyses, and generalized estimating equations. For purchase decisions, healthier choices increased by 7.62–21.96 percentage points in the combined group versus 3.46–7.83 in the label-only group, with significant between-group net effects in five of six pairs after Holm correction. For healthfulness evaluations, improvements were 12.89–34.85 versus 6.19–9.29 percentage points, with significant between-group net effects in five of six pairs after Holm correction. Transition analyses showed larger shifts from non-healthier to healthier responses in the combined intervention group. Heterogeneity by sex and objective nutrition information literacy was significant only for healthfulness evaluations, with women and those with higher objective nutrition information literacy having additional benefit from the combined intervention. Therefore, adding nutrition education to FOP labels may promote healthier judgments and simulated choices for freshly prepared beverages.