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The prevalence of overweight and obesity is increasing at an alarming rate(1,2). Globally, approximately 1·6 billion adults are overweight and over 400 million are obese(2). Although obesity is more common in high-income countries, increases in obesity have occurred in many low- and middle-income countries, particularly among urban populations(2). The increasing prevalence of overweight and obesity places a considerable burden on public health, including increases in CVD, diabetes, arthritis, sleep and breathing disorders, depression, as well as functional limitations(3). Diet is also estimated to account for approximately 30 % of cancers in industrialized countries, making it the second largest modifiable risk factor after cigarette smoking(4). The economic burden of overweight and obesity is considerable, with direct health-care costs in the billions for most Western countries(5).
Nutrition labelling on food products has emerged as a prominent policy tool for promoting healthy eating(6). As a health education intervention, mandatory nutrition labels have broad reach and are present at the point of purchase, as well as when food is prepared or consumed(7). The display of nutritional information on pre-packaged foods is mandatory in most high-income countries. In the USA, the Nutrition Labelling and Education Act of 1990 mandates that pre-packaged foods carry a nutrition label, with exceptions for foods intended for immediate consumption(8). In Canada, mandatory nutrition labelling was first implemented on pre-packaged foods in December 2005 and became mandatory on virtually all pre-packaged foods in 2007(8-10). Nutrition labelling on pre-packaged foods remains voluntary in the European Union, except in the case of health claims, although mandatory regulations are under development(11) (see Fig. 1 for examples of nutrition labels in the USA, Canada, Australia and the UK).Fig. 1
Examples of nutrition labels on pre-packaged foods
There is a large and growing evidence base on the impact of nutritional labels, including six literature reviews between 1991 and 2007(6,12-16). The most recent reviews have focused on specific geographical areas, including...