Awareness, Understanding, and Use of Nutrition Labels on Pre-Packaged Foods and Their Associations with...

Background: Noncommunicable diseases (NCDs) are a major global public health challenge and can be prevented and managed through a balanced, nutrient-rich diet. Food nutrition labels play an important role in guiding healthier choices, particularly for individuals at risk of chronic health conditions. This study assessed awareness, understanding and use of nutrition labels among adults in Shanghai, China, and explored their associations with NCDs. Methods: A face-to-face structured questionnaire survey was conducted among 1503 adults in 2024. Data were collected on sociodemographic characteristics, self-reported chronic conditions (obesity, diabetes, hypertension, hyperlipidemia, hypercholesterolemia, cardiovascular and cerebrovascular diseases (CCVDs), and fatty liver disease), and awareness, understanding, and use of nutrition labels. Generalized linear regression models were applied to assess associations between label-related behaviors and chronic conditions. Results: Overall, 81.6% of participants were aware of labels, 15.0% reported understanding them, and 35.5% reported using them. Participants who were underweight or obese were less likely to be aware of labels compared to those with normal weight (73.8% and 72.9% vs. 83.5%). Individuals with fatty liver disease were less likely to understand labels compared to those without the condition (7.2% vs. 16.1%). Conversely, participants with three or more chronic conditions were more likely to use labels than those without any chronic conditions (46.1% vs. 34.4%). Conclusions: Among adults in Shanghai, nutrition label awareness was relatively high, while understanding and use of labels remained insufficient. Targeted nutrition education and the integration of nutrition labeling into chronic disease management strategies are needed to improve public health outcomes.