Supermarket shelf labels help African Americans, others shop healthier, study finds

ANN ARBOR, Mich. - Color-coded labels placed on supermarket shelves to mark healthier food choices are effective in helping guide African Americans and others in their grocery shopping, a new study from the University of Michigan shows. The education program may help shoppers lower their risk of diet-related health problems such as heart disease.

The finding, which adds to similar evidence already gathered among predominantly white populations, was made by dietitians and others from the U-M Health System's Heart Care Program and M-Fit Health Promotion Division. It is published in the Journal of the American Dietetic Association.

"Given the epidemic of heart disease that we see in African Americans, and the difficulty in reaching them with health messages, we're encouraged that this kind of nutrition advice at the point of purchase seems able to encourage healthy behavior," says Kim Eagle, M.D., chief of cardiology at UMHS, co-director of the Heart Care Program and a co-author on the paper.

The study looked at the effect of the M-Fit Shelf Labeling Program on shopper awareness and behavior after one year's use in 18 Detroit-region supermarkets. It used a simple survey given at store exits to 361 shoppers, a cross-section sample that was 67 percent African American, 66 percent female, and 84 percent high school graduates.

The program's dietitians have analyzed nutrition information for most products in the Detroit supermarkets, and determined which should receive a green "best choice" or yellow "acceptable choice" label understandable by shoppers at all education levels. Foods receive the labels on the basis of total fat, saturated fat, fiber, cholesterol, and sodium content. The program's recommendations are in line with the Dietary Guidelines for Americans given by the U.S. Department of Agriculture. Over 3,760 products received labels, while in-store signs, books and banners helped explain the shelf labeling program further.

vcb In all, 28 percent of surveyed shoppers said they were aware of the M-Fit shelf labels and program. African Americans were twice as likely to be aware as whites shopping in the same supermarkets. The difference remained after adjustment for age, gender and education level.

Most who had noticed the labels had used them. Fifty-six percent of those who knew about the program reported using it to guide their choices. Thirty-nine percent of respondents said they used the program a little or sometimes, while another 17 percent used it often or always.

Those who had had a heart-related screening, such as a cholesterol or blood pressure test, in the past year seemed far more than likely to notice the shelf labeling program than those who had not.

"Package nutrition labels can be confusing, but this simple color-coding tells shoppers at a glance which foods they could make a part of their regular diet, and which should be enjoyed in moderation," says Holly Noble, R.D., who currently coordinates the M-Fit supermarket program. "Based on this study, it appears that they're seeing and using it."

Though the stores used in the study do not currently participate in the shelf-labeling program, Noble and her colleagues have worked since 1991 with other Michigan and Ohio stores to implement the color-coded shelf labeling system. More than two dozen stores in the Busch's, Whole Foods, and Heinen's chains are currently participating.

Another 56 stores in Michigan and Wisconsin are working with M-Fit to provide "shelf talker" cards that help shoppers identify "best" and "acceptable" choices using the products' own nutrition labels.

A current list of stores can be found on the World Wide Web at M-Fit's programs are believed to be unique in the nation, because they are targeted at all shoppers rather than people with existing diabetes, heart disease, or other conditions. Like previous successful test programs elsewhere, M-Fit's offerings are supermarket-based, rather than relying on a guide that shoppers must obtain elsewhere. The program's dietitians constantly review new food products and rate them for participating stores so that shelf labels can be updated.

Other studies have showed that consumers are hungry for such information. The Food Marketing Institute recently found that 83 percent of shoppers say it is very or somewhat important that a supermarket offer nutrition and health information. Fifty-seven percent of consumers use nutrition and health information offered by their supermarkets at least once a month.

M-Fit also helps consumers make healthier choices in local restaurants by identifying healthier menu choices with and M-Fit logo on the menu. Participating restaurants are listed on the M-Fit website, http://www.mfitnutrition.com.

"Our aim is to get shoppers and diners to think about their choices," says Noble. "We provide them with the information they need at a glance, so it's much easier."

The paper in the Journal of the American Dietetic Association is based on work by Eagle and several colleagues who have since left UMHS: Jason Lang, MPH, M.S., Nelda Mercer, M.S., R.D., and Lori Mosca, M.D., MPH, Ph.D. The M-Fit program is directed by Sharon Sheldon, MPH.