Who is missing the message? Targeting strategies to increase food label use among US adults

To evaluate the associations between sociodemographic and psychosocial characteristics and food label (FL) use in US adults.

Data from the 1994-1996 Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey were used. High socio-economic status (SES) was defined as >high school education and poverty-income ratio (PIR) >350 %, low SES as

Metropolitan statistical area-central city, -suburban, and rural areas in the USA.

US adults (n 2797; 1460 men, 1337 women) aged 20-64 years.

Approximately 80 % of Americans reported using FL, including checking the nutrition panel, list of ingredients, short phrases, serving size, or health benefits. Only 26 % used all FL information. Compared with white women of higher SES, white men, black men and women with lower SES were 77-90 % less likely to use FL. Rural residents were 40 % less likely (OR = 0.60; 95 % CI 0.42, 0.86). Participants with good nutrition knowledge, perceptions and beliefs were twice as likely to check FL for nutrient content of foods (OR = 2.28; 95 % CI 1.53-3.40). Those who were unaware of diet-disease relationships were less likely to use FL (OR = 0.53; 95 % CI 0.32-0.85). Among overweight/obese Americans (BMI ≥ 25 kg/m2), those who perceived their weight 'about right' were 51 % less likely to use FL than those perceiving themselves as overweight.

Men, especially black men, women of low SES, rural residents and overweight Americans with inaccurate self-perception of body weight are less likely to use FL and should be targeted for increased intervention.