The Readiness of Sugar-Sweetened Beverage Industry in Ghana for Mandatory Nutrition Labelling; Consumer Understanding and Perception of Nutrition Labelling

Abstract

Background: Increased consumption of sugar-sweetened beverages (SSB) among all age groups is a global public health concern due to its association with non-communicable diseases (NCDs). In response to this concern, some countries are employing multifaceted policy interventions that includes mandatory nutrition labelling of pre-packaged foods to control the rise in diet-related NCDs rates. Policy markers require current information on the readiness of the food and beverage industry, and consumers to effectively implement mandatory nutrition labelling. Objectives: The study sought to determine whether SSB manufacturers are ready for future mandatory nutrition labelling, as well as consumers’ use and understanding of nutrition label information, and their perception about mandatory nutrition labelling. The study further sought to determine the caloric load of SSBs commonly consumed by study respondents. Methods: An in-depth interview with representatives from SSB manufacturing companies were conducted to assess the industry’s readiness for mandatory nutrition labelling. SSB consumers were also interviewed by using a semi-structured questionnaire at supermarkets located within some shopping malls/centres in the Greater-Accra Region. Based on a consumer survey, five commonly consumed SSBs were selected and analyzed for their caloric content. Interviews with SSB companies were transcribed and summarised under five readiness constructs themes (change commitment, change valence, task knowledge, resource availability and change efficacy. Logistic regression analysis was used to determine the association between various factors and consumers’ use and understanding of nutrition information. Results: Twelve (12) SSB manufacturing companies were recruited for the study and 11 were large scale manufacturers. From the key informant interviews, respondents exhibited high change valence, task knowledge and resource availability. Stakeholder engagement was found to be a potential driver whilst financial resource and lack of expertise may serve as barriers of the policy. Based on the consumer survey, a majority (73%) of the study respondents were users of nutrition information on food labels, 66% were found to have high knowledge in nutrition and 59% of the respondents had a high understanding of nutrition labels. Respondents’ use of nutrition labels was dependent on high nutrition knowledge (AOR, 0.58; 95% CI, 0.37-0.92; p=0.020). Having a high educational level (AOR, 0.21; 95% CI, 0.06-0.70; p=0.011), being unmarried (AOR, 0.51; 95% CI 0.29- 0.88; p = 0.016) and having a high nutrition knowledge (AOR, 0.39; 95% CI, 0.26-0.61, p<0.001) were found to be associated with respondents’ understanding of nutrition label information. About 83% exhibited positive perception about mandatory nutrition labelling. Mean caloric load of SSB usually consumed by the study respondents was 36.58 ±22.142 kcal (range 0.820 ± 0.006 to 55.100 ± 0.590 kcal). Conclusion: Large scale SSB manufacturers are ready to implement mandatory nutrition labelling whereas the only medium scale manufacturer was not ready. SSB industry’s involvement at the planning stage of the policy would be a major driver for the policy. However, financial implications may serve as a barrier to policy implementation. Consumers had positive perceptions about mandatory nutrition labelling and would use nutrition information as a guide for healthier food selection. Educational programmes on nutrition label use must consider specific limitations of consumers with low nutrition knowledge, and educational levels. SSB should be consumed in moderation.