Agricultural Sciences

Low use of nutrition labels contributes to health disparities in China

The findings could be used to craft policies to help reduce the disparity in diet quality and health, according to the researchers. Credit: Photo by Priscilla Du Preez on UnsplashAll Rights Reserved.

UNIVERSITY PARK, Pa. — Nutrition labels can help guide consumers toward making healthier food choices, but new research suggests that a lack of knowledge about how to use them may be contributing to nutrition gaps between people in urban and rural China.

The study — led by a researcher in Penn State’s College of Agricultural Sciences — found that rural respondents had less knowledge, lower usage and fewer perceived benefits of nutrition labels than their urban counterparts.

Additionally, the researchers found that less focus on food safety, less education about labels, fewer available shopping locations and lower income could explain nearly 99% of the disparity in nutrition label knowledge.

Linlin Fan, assistant professor of agricultural economics, said the findings — recently published in the journal Nutrients — could be used to craft policies to help reduce the disparity in diet quality and health in China.

“Policies that increase household income and education, improve attention to food safety and enhance the availability of large grocery stores in rural areas,” Fan said, “could be beneficial to closing the urban-rural disparity in the knowledge, use and perceived benefits of nutrition labels in China.”

According to Fan, previous research has shown that consumers who frequently use nutrition labels have better diets and lower risks of diet-related comorbidities. For example, one study found that using nutrition labels reduced daily cholesterol, sodium and daily calorie intake from saturated fat while also increasing average daily fiber intake.

At the same time, gaps exist in diet-related chronic diseases and nutrition between urban and rural Chinese residents. Previous studies found that rural residents have higher prevalence of hypertension, heart disease, cerebrovascular disease, peptic ulcer and chronic cholecystitis, among other conditions.

“We suspected that disparities in the knowledge and use of nutrition labels may contribute to disparities in diet quality and related health problems between urban and rural consumers,” Fan said. “We wanted to analyze whether there were differences in whether and how rural residents used nutrition labels compared to urban residents, as well as how those disparities could be reduced.”

For the study, the researchers analyzed data from 1,635 individuals between the ages of 11 and 81 across China. They found that compared to their urban counterparts, the number of rural respondents who did not have a good understanding of nutrition labels was about 9.4% higher, the number of rural respondents who did not use nutrition labels was nearly 14.9% higher, and the number who perceived little or no benefits from nutrition labels was almost 8.9% higher.

In addition, nutrition label knowledge was the predictor that contributed most to the urban-rural disparity in label use, accounting for 29.6% of the difference. Nutrition label knowledge and use were the two biggest predictors of disparities in perceived benefits, accounting for 29.7% and 22.8% of the difference, respectively.

Fan said one surprising finding was that, while higher income was associated with better knowledge and more frequent use of nutrition labels, higher income also was associated with decreased perceived benefits of nutrition labels.

“It’s possible that people with higher income are willing to spend more money to purchase food with higher perceived quality, such as organic food,” Fan said. “In this regard, they are already confident with the quality of food and do not use or recognize benefits from nutrition labels.”

Fan added that while the study was done in China, the findings also may apply to people in the U.S. For example, previous research has found that rural Americans also face elevated rates of morbidity and mortality and greater percentages of excess deaths from diet-related chronic conditions, such as cardiovascular disease and diabetes, compared to urban counterparts.

“Our study suggests that income, education, attention to food safety and large grocery store availability are all important predictors of nutrition label knowledge, use and health, which may apply to the U.S. context, as well,” Fan said. “Policies aiming to enhance income, education, food safety awareness and access to large grocery stores also may be helpful to increase diet quality and health in rural America and reduce the urban-rural disparity in the U.S.”

Zhigang Wang, Renmin University of China; Yiwen Zhao, doctoral student in the College of Agricultural Sciences at Penn State; and Ye Ma, Ministry of Agriculture and Rural Affairs in Beijing, also participated in this work.

The China National Natural Science Foundation and U.S. Department of Agriculture National Institute of Food and Agriculture and Hatch appropriations helped support this research.

Last Updated April 25, 2023

Contact