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

OBJECTIVE: To evaluate the associations between sociodemographic and psychosocial characteristics and food label (FL) use in US adults. DESIGN: 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 <high school level or PIR <130 %. Dietary intakes were assessed using 24 h recalls. SETTING: Metropolitan statistical area-central city, -suburban, and rural areas in the USA. SUBJECTS: US adults (n 2797; 1460 men, 1337 women) aged 20-64 years. RESULTS: 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. CONCLUSIONS: 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.