Title: Impact of Food labels on Food Choice in Mauritius Prity Pugo Gunsam
ABSTRACT
Background: Food labels serve the purpose of protecting consumers and helping them make informed
dietary choices that will contribute to a healthy diet. In Mauritius where there is a high incidence of
nutrition related disorders amongst the population, correct deciphering of food labels may help informed
food choices and prevention of disorders linked to unhealthy nutrition. Aims and objective: This study
aims at finding out about (i) overall consumers’ perception and understanding of food labeling and its
health-related benefits in the Mauritian population, (ii) how obese consumers perceived their eating habits
and whether food labels help them in making informed choices. Methods: For the purpose of this study, a
questionnaire-based survey was carried out in a random sample of 155 participants of different age groups
living in both rural and urban areas. Results: A lack of understanding in relation to food labels was noted,
more specifically concerning nutrition information and the terminologies employed. Consumers were
conscious of the importance of food labels. Even if 82.6% of all participants stated that they read food
labels, and 95.7% of this group claimed that reading food labels influenced them in their food choices,
investigations regarding eating habits showed that consumers had insufficient knowledge about healthy
eating habits. Participants with higher level of education used food labels more frequently than those
having a lower education level; but, a strong need for simplified food labels was expressed by all
participants.
Conclusion: It can be concluded that for more efficient use of food labels, consumers need to have a
better understanding of the labels. Therefore, concerned authorities should consider redesigning food
labels, with less technical terms used to cater for the demand of the Mauritian population. Our results also
highlight that consumers in Mauritius have a great need to be sensitized about the disastrous
consequences of unhealthy eating habits.
Keywords: Food labelling, consumers, understanding, perception, obesity, adverse effects, education
level, eating habits, Mauritius.
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INTRODUCTION
Urbanization and globalization have brought major changes in lifestyles, which have
unfortunately contributed to the rise in the prevalence of non-communicable diseases. Unhealthy
diet and physical inactivity are the leading causes of the major non-communicable diseases
(Mehan, 2006), which include obesity, diabetes mellitus, cardiovascular disease, hypertension,
and osteoporosis.
Obesity by itself has several adverse effects which may result in other non-communicable
diseases such as diabetes mellitus and cardiovascular disease. In Mauritius, the prevalence of
diabetes mellitus is alarmingly high and that of obesity is on the rise. Prevention of these
conditions would greatly help in improving the quality of life and well-being of people and
societies (WHO, 2006). Adopting healthy diets is one way of achieving this. For this purpose,
food labelling can be used so that consumers have a better idea of what they are eating and thus
have a means of improving their diets.
Public authorities and legislations provide precise guidelines and help ensure uniformity of food
labels. However the legislations may differ among countries or regions. Mauritius is part of the
Southern African Development Community (SADC), whose members need to develop their
legislation according to the Codex Standards, and in 1999 the Food Labelling Regulations was
passed under the Food Act 1998.
Food labels have much importance in providing valuable information, which can protect
consumers and help them make informed dietary choices that will contribute to a healthy diet.
Indeed, food labels contain information about the contents of food products and their nutritional
values, as well as recommended intake for normal individuals.
Throughout the years, Mauritians have changed their eating pattern, such that many more
individuals purchase their food ready-made instead of consuming home-made food. Therefore, it
is primordial for consumers to be knowledgeable about food labels so that they may discriminate
among the wide variety of food products available in supermarkets nowadays, some of which
may be detrimental to their health. Moreover, there are now more and more food products being
imported from abroad, implying diversity in the food labels displayed to the consumers.
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According to a survey done in Maurtius, NCDs are a major threat to public health, and indeed, it
was found that 10 % of the adult population was obese and that 25 % was overweight (Ministry
of Health and Quality of Life, 2004). There has been a gradual increase in the prevalence of
obesity in the last twenty years. Thus, a lot of Mauritians have forgone healthy eating habits.
With the increase in consumption of pre-packaged food, it is important to assess whether
Mauritians are knowledgeable about food labelling, its benefits and its health-related importance.
The comments and criticism of Mauritian consumers may prove helpful to improve food
labelling, and to determine if there is a need to educate consumers about food labels.
MATERIALS AND METHODS
Experimental design and Subjects
For the purpose of this study, a questionnaire-based survey was carried out. The sample
population comprised of 155 respondents chosen at random and assessment of the sample
population was conducted between December 2006 and January 2006. Data was collected from
78 men and 77 women belonging to different age groups and coming from different regions of
Mauritius, including both rural (50.7%) and urban (49.3%) regions. The majority of respondents
aged between 20 and 60. Most of the participants belonged to an average socioeconomic level.
In order for the subjects to be able to participate in the study, a criteria-inclusion scheme was
followed. The participants were required to be reliable, willing to take part, taking no
medications that might interfere with the study results, and to have a regular meal pattern. They
all lived in their homes. Before the study began, the purpose and objectives were carefully
explained to the subjects. Informed consents were obtained from them.
Dietary survey
Data on the awareness, perception and understanding of consumers regarding food labels and
obesity was collected by an interviewer-administered food-frequency questionnaire (FFQ). A
pilot survey was conducted with fifteen individuals chosen at random before finalizing the
questionnaire. Subsequent modifications and adjustments were made where needed to improve
the questionnaire.
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Before designing the questionnaire thorough documentation was done, notably on food labelling,
related regulations, and obesity. The questions were defined in such a way as to fulfill the
objectives of the study and were arranged in a continuous, logical order to finally come up with a
7-paged questionnaire consisting of 35 questions. Three main areas were covered, namely
awareness and perception of food labelling, health concern and personal data.
Anthropometric measurements
Height and weight were measured without the subject wearing shoes nor any jewel. Weight was
measured to the nearest kilogram (kg) with subjects with emptied pockets. A calibrated weighing
platform scale with weighing capacity of 130 kg was used. Height was measured to the nearest
centimeter (cm) by means of a measuring tape with a steel tape joined to a level platform to
facilitate holding of the measuring tape at the bottom while taking the height at head level. From
the anthropometric data, body mass index (BMI) was calculated (kg/m2) and was used to grade
the subjects into normal weight, overweight and obese. A subject having a BMI >30 was
considered obese.
Data Analysis
Statistical analysis was performed with the use of SPSS 10.0 for windows and Microsoft Excel.
SPSS was used mostly for frequency analysis, cross-tabulations among others, while Excel was
used especially for presentation of data and graphical representations.
RESULTS
Socio-demographic characteristics of the study population
Table 2 shows the socio-demographic characteristics of the elderly participants in the study.
Consumers and Food Labels
Among the study population, 82.6% of respondents declared reading food labels, against 7.4%
who did not read food labels. It was found that 43.2% of respondents who read food labels were
females and 39.4% were males. Moreover, the highest percentage of respondents who read food
labels was recorded in the 40-60 age group (25.8%). The proportion of respondents aged above
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60 years and less than 20 years who read food labels was 4.5% and 5.2% respectively. The study
also revealed that the majority of respondents who read food labels had secondary education
(40.3%) and tertiary education (33.8%).
Respondents who read food labels were asked if it had an influence on their purchase of food
products, and for which reasons. 95.7% of these stated that reading of food labels did have an
influence of their purchase against only 4.3% who reported not being influenced.
Respondents gave varying ways in which reading food labels influenced their purchase as seen in
Figure 1. The majority of respondents (20.4%) declared being influenced by the expiry date.
Products that were close to expiration were rejected. 18.4% of respondents reported choosing
best quality products and 17.5% of respondents reported choosing food products deemed to be
good for health. Moreover, 93.7% and 78.7% of our study population claimed that they found the
information on label useful and easy to understand, respectively. In fact, 39.7% of respondents
who found food labels easy to understand had secondary education.
The most widely used label components include expiry date (90.9%), ingredient list (70.1%),
nutrition information (63.0%), storage instructions (61.7%) and country of origin (59.1%). These
were followed by health claim (4.3%), nutrient claim (36.4%), GMO declaration (19.4%) and
lastly, health claim duplication (10.4%). These are shown in Figure 2. By far the most easily
understood label element was found to be expiry date (73.9%).
Consumers and Food Labelling Regulations
In our present study, 81.9% believed that consumers in Mauritius did not have enough
information about the food labelling regulations, and 84.6% were in the opinion that the
regulations were not being consistently followed as can be seen in Figure 3.
In case of non-conformity of food labels, respondents were questioned about their reactions. As
can be seen in Figure 4, 54.2% of respondents would choose to ignore the product, 34.7% would
inform the retailer or other appropriate person, 6.3% would report to authorities and 4.9% would
ignore the breach and buy the product.
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Improvements and Consumer Appreciation
Respondents were asked to suggest improvements they would like to see concerning food
labelling. The majority of respondents suggested that the labels should be written in simpler
terms and that more details should be added (18.5% for both). Other suggestions include clearer
labels (14.7%), larger characters (14.7%), more information on nutrition values (9.5%), and more
information on additives (7.4%).
Respondents were also enquired about what they liked in food labelling. 41.7% stated that food
labelling provided important information to consumers, and 23.8% specified that the information
helped consumers make better food choice. 14.7% of respondents expressed their satisfaction
with the presentation of food labels and 11.9% with the information on ingredients.
Obesity and Food labelling
Our study showed that 29.1% and 4.5% of respondents were overweight and obese, respectively.
The highest percentage of obesity was recorded in the 40-60 age group (50%) and that of
overweight in the 30-<40 age group (33.3%). Moreover, we note also that twice of as much
obese males were recorded than females.
The highest percentage of respondents reported checking fats, cholesterol, additives, and
calories. As can be seen in Figure 5 the most frequently checked nutrient was cholesterol
(35.7%), followed by fats (29.3%).
DISCUSSION
Respondents were asked whether they read food labels and if yes, whether it influenced their
purchase and for what reasons. 82.6% of all respondents stated that they read food labels,
whereas only 17.4% declared that they did not read the labels as shown. This suggests that
consumers have a certain interest in food labels and perceive the latter as having at least some
importance. Of all respondents, 39.4% males and 43.2% females stated they read food labels as
shown in Figure 4.4. Therefore, there is no major difference in the reading of labels between
males and females. The slight difference obtained may perhaps be explained by the fact that
women are most of the time responsible for buying food for the family. Also, women tend to be
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more concerned about diet, for instance, to control their weight and are thus more attentive and
careful to what is written on the food labels.
Marked differences were obtained in respondents with dissimilar levels of education. The highest
percentages were found in those having secondary (40.3%) and tertiary (33.8%) education.
Participants who went to primary schools only had the lowest percentage of label use (7.1%).
These results indicate that the level of education may have a notable influence on the use and
understanding of food labels. People with a higher level of education may be more aware of the
importance of food labels and of the potentially harmful nature of certain ingredients contained
in some food products. Also, the results can be explained by the fact that people with only
primary level education may not be completely literate and therefore, may not understand the
meaning of what is written on the labels, especially due to the use of technical and scientific
terms.
The majority of respondents stated that they were very concerned about the expiry date (20.4%),
as shown in Figure 1. Some respondents claimed that if the expiry date was only a few weeks
away, they would not buy the product at all. This indicates that the perceived importance of food
labels resides mostly in the expiry date, as people tend to believe that poisoning may result from
the consumption of expired food products. Moreover, if food is purchased on a monthly or
fortnightly basis, it is crucial for consumers to verify that the product is not too close to
expiration, or else they might be on the losing side altogether. In accordance with the observed
trend until now, expiry date is the most easily understood food label element.
Secondly, a large number of participants were concerned about buying the best quality products
(18.4 %). This was closely followed by health consciousness expressed by respondents. These
results suggest a growing concern about health issues as, indeed, the incidence of noncommunicable diseases is on the rise. Consumers are getting increasingly demanding and
selective about the quality and nutritional values of the food products they consume.
Food labelling regulations are indispensable as they provide the consistent standards consumers
need to make food choices in an ever-changing food industry (Karen Hare, 2004). It is to the
advantage of consumers to be knowledgeable about the regulations pertaining to food labelling
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so that any breach of the regulations may be reported to appropriate authorities. The awareness
and perception of consumers about these regulations were investigated in this study.
A majority of 67.7 % of the sample populations were aware of these regulations, which is quite
encouraging. However the remaining 32.3 % were ignorant of these regulations and this is not a
negligible percentage. Therefore, it can be seen that there is a need to inform consumers in
Mauritius about food labelling regulations.
Participants, when asked about what improvements they wished to see concerning food labelling,
gave varying answers. The study identified a major need expressed by respondents for labels to
be written in a more simplified way with less technical terminologies employed (15.8%). In
addition, respondents asked for clearer, more visible labels consisting of larger characters. This
would definitely improve the ease of comprehension of consumers, and therefore optimize the
use of food labels for improved food selection. Request for more details (15.8 %) was also
expressed and small fractions of respondents specified the need for details about nutrition values
such as fat, sugar contents and calories, and about additives.
Respondents also expressed their satisfaction concerning the presentation of labels, which were
often qualified as “attractive”. Therefore it can be suggested that consumers tend to read food
labels which they find appealing. This might be used at their own advantage to induce them in
reading food labels.
Anthropometric measurements were taken and the BMI was subsequently calculated. According
to an NCD report (Ministry of Health and Quality of Life, 2004), 35.7 % of the Mauritian
population aged 20-74 years are either obese or overweight. In our sample population, 33.6 % of
respondents were either obese or overweight. This is quite representative of the actual situation
in the country.
To determine which food components are considered in food choice, respondents were asked
which nutrients they checked on food labels, and the reasons behind their choice. It was found
that cholesterol and fat contents were checked most often, with a percentage of 35.7 % and 29.3
%, respectively Cholesterol was largely associated with health problems by respondents (25 %).
This indicates the level of general awareness and health consciousness among participants.
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However, most respondents did not seem to know exactly how cholesterol affected health. Some
respondents (4.8 %) believed that obesity or weight gain could result from excessive intake of
cholesterol, indicating a degree of misunderstanding among consumers. 1.2 % of respondents
specified that cholesterol was associated with hypertension, thus accounting for their choice.
Excessive consumption of fat was associated with health problems (11.9 %), obesity or weight
gain (10.7%), and diabetes (1.2 %). People generally tend to link fat and weight gain. Therefore,
the reason provided by the respondents is not surprising. More knowledgeable and aware
respondents made the connection between diabetes and fat intake. However, they were quite few,
showing the lack of awareness among consumers. Bearing in mind that the incidence of diabetes
in Mauritius is alarmingly high, consumers should normally have been more informed on the
whole.
To find out about the general attitude regarding obesity and food labelling, respondents were
asked to rate a series of statements. To the statement “control of body weight is important”, the
high percentage of 81.6 % of respondents claimed to strongly agree. Therefore, by far, the
majority of respondents were in agreement with the statement. They are thus aware to some
extent of the importance of maintaining a steady body weight as indeed obesity is associated
with decreased survival and medical complications (Villareal, 2005).
It was important also to determine to what extent consumers believed that food labelling could
help in promoting healthy eating habits and in maintaining a constant body weight. The majority
of respondents agreed to both statements. 33. 8% and 39.7% of respondents strongly agreed and
moderately agreed to the statement “food labelling can help consumers control their weight”,
respectively. Regarding eating habits, 38.4% strongly agreed and 39.7% moderately agreed that
food labelling could promote healthy eating habits. Therefore consumers are aware to some
extent of the health-related importance of food labelling.
CONCLUSION
The study aimed at gaining some insight on the connection between food labelling and the
prevention of health disorders, more specifically of obesity in Mauritius. For this purpose,
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consumers’ knowledge, awareness, perception and understanding of food labels and obesity were
investigated.
The most remarkable outcome of this study is a general lack of knowledge at various levels. It
was noted that the level of education impacted heavily on whether consumers used or not food
labels. Consumers having received a low level of education were found to use food labels to a
much lesser extent than those with higher levels of education. Moreover, consumers on the
whole expressed a strong need for clearer food labels, written in a simplified way. Food labels
with complicated terminologies are truly useful to the few people familiar with them only. For
the rest of consumers, those terms fail to serve the very purpose for which they were made.
Instead of helping consumers make informed food choices, they may discourage consumers, the
latter being probably left confused after reading the labels. The results obtained also suggest that
simplified information could help raise consumers’ interest in food labels.
Overall, it was noted that consumers in Mauritius do value the importance of food labelling.
However, due to a lack of knowledge on this matter, they often fail to use food labels to their
advantage so as to improve their eating habits. In spite of being aware, to some degree, of the
types of food components that contribute the most to obesity, it was recognized that consumers
had an inadequate notion of what healthy eating habits were. The media may be partly
responsible of this, as it provides consumers with a lot of information on nutrients and their
health-related benefits, in complicated, scientific terms, which most consumers do not fully
comprehend.
In the light of the information gleaned by this study, I would recommend that food labels are
redesigned in a more consumer-friendly way. Easily accessed health information concerning
food labelling should be provided to consumers to raise their knowledge and awareness, and
allow improved food choice. Consumers need to be sensitized about the disastrous outcomes
resulting from the consumption of unhealthy food products. This is of capital importance given
the incidence of obesity and its adverse effects in Mauritius.
Consumers need to learn how to make proper use of the wealth of information provided on food
labels. However, for a significant improvement of the general health of the public to be
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registered, consumers must be prepared to adopt more healthy eating habits. And this will indeed
prove to be the most challenging step towards a healthy nation.
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Table 4.1: Socio-demographic characteristics of respondents.
Personal Data
Age
Gender
Area of residence
Ethnic group
Level of studies
Occupation
Family status
Monthly income per family
Frequency
Percentage
<20
9
5.8
20-<30
47
30.3
30-<40
47
30.3
40-60
44
28.4
>60
8
5.2
Male
78
50.3
Female
77
49.7
Rural
76
50.7
Urban
74
49.3
Mauritian-Creole population
33
22.1
Sino-Mauritian
16
10.7
Indo-Mauritian
99
66.4
Franco-Mauritian
1
0.7
Primary
19
12.3
Secondary
70
45.5
Tertiary
63
40.9
Others
2
1.3
employed
99
65.6
unemployed
24
15.9
retired
5
3.3
student
23
15.2
Single
65
41.9
Married
89
57.4
<5000
9
6.1
5000-<10 000
39
26.5
10 000-20 000
36
24.5
>20 000
63
42.9
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Label elements used
19.4
GMO declaration
Storage instructions
Health claim duplication
Nutrient claim
Health claim
Ingredients list
Country of origin
Nutrition information
Expiry date
61.7
10.4
36.4
40.3
70.1
59.1
63
90.9
0
20
40
60
80
Percentage of respondents (% )
Figure 1: Label elements used by respondents.
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100