Packaged food consumption and understanding of front-of-pack labels in urban Thailand

Objectives: We assessed the use of current guideline daily amount (GDA) label and consumers' ability to read GDA, compared with GDA-plus labels (green colour-coded GDA [GGDA], GDA label with text [GDAT] and green colour-coded GDA label with text [GGDAT]) in Thailand. Study design: This is a cross-sectional study. Methods: We interviewed individuals at 23 major supermarkets across the country in March 2015. We used a mixed multivariate logistic regression model to identify factors associated with the ability to make healthier choices when reading front-of-pack (FoP) labels. Results: Of 1364 participants, only 11% claimed to read the GDA label every time; those who did not read the main reason was that it was not understandable or attractive. In total, 65%, 62%, 61% and 39% were able to read GDAT, GGDAT, GGDA and GDA labels, respectively. When reading GGDA, GDAT and GGDAT labels, participants were 2.91 (95% confidence interval [CI]: 2.45, 3.45), 3.59 (95% CI: 3.01, 4.28) and 3.13 (95% CI: 2.63, 3.72) times more likely to choose healthier food choices compared with having read an ordinary GDA label. Participants who were exposed to food selection guidelines were more likely to make healthier food choices when reading FoP labels with different odds depending on sources of information. Participants who recognized the link between diet and non-communicable diseases were 1.21 (95% CI: 1.02, 1.44) times more likely to choose healthier food choices. No sociodemographic characteristics were significantly statistically associated with the ability to choose healthier food choices when adjusted for diet-related knowledge and FoP formats. Conclusions: Use and understanding of GDA are still low, mainly because GDA is incomprehensible and unattractive. Interpretive FoP formats tend to be more understandable and need less complementary public campaigns compared with non-interpretive formats. (C) 2019 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.