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The Impact of the Nutri-Score Nutrition Label on Perceived Healthiness and Purchase
Intentions
Joyce De Temmerman, Eva Heeremans, Hendrik Slabbinck, Iris Vermeir
PII: S0195-6663(20)31617-2
DOI: https://doi.org/10.1016/j.appet.2020.104995
Reference: APPET 104995
To appear in: Appetite
Received Date: 14 January 2020

Revised Date: 10 September 2020
Accepted Date: 30 September 2020
Please cite this article as: De Temmerman J., Heeremans, E., Slabbinck, H. & Vermeir, I., The Impact
of the Nutri-Score Nutrition Label on Perceived Healthiness and Purchase Intentions, Appetite, https://
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ABSTRACT
Making healthier food choices easier at the time of purchase is a challenge for public
policy makers. The Nutri-Score can be an effective tool for guiding and steering consumers
toward more informed, healthier purchasing decisions. This research investigates the impact
of the presence of the Nutri-Score and its five categories on consumers’ perceived healthiness
perceptions and purchase intentions. Consumers in the EU took part in two online
experiments, in which they rated products from different categories, with or without Nutri-
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Scores, in terms of their perceived healthiness and purchase intentions. The presence of the
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Nutri-Score enabled participants to assess the healthiness of products better; furthermore, it
offers the potential to boost sales of healthy products, without affecting sales of unhealthy
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products. Perceived healthiness mediates the relationship between Nutri-Score categories and
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purchase intentions, and focusing on the healthiness of products can give producers a
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competitive advantage, regardless of whether it is a manufacturer brand or a private label.

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These findings offer actionable insights for public policy makers and manufacturers; they also
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suggest the need to embrace the Nutri-Score as the standard front-of-pack label to help fight
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the increasing obesity pandemic.

The Impact of the Nutri-Score Nutrition Label on Perceived
Healthiness and Purchase Intentions
Joyce De Temmerman,* Eva Heeremans, Hendrik Slabbinck, Iris Vermeir
Faculty of Economics and Business Administration, Ghent University, Tweekerkenstraat 2,
9000 Ghent, Belgium
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Declarations of interest: none

*
Corresponding author. Tel. +32 9 264 35 67.
E-mail addresses: Joyce.DeTemmerman@UGent.be (J. De Temmerman), Eva.Heeremans@Gent.be (E.
Heeremans), Hendrik.Slabbinck@UGent.be (H. Slabbinck), Iris.Vermeir@UGent.be (I. Vermeir).
1
1 ABSTRACT
2 Making healthier food choices easier at the time of purchase is a challenge for public
3 policy makers. The Nutri-Score can be an effective tool for guiding and steering consumers
4 toward more informed, healthier purchasing decisions. This research investigates the impact
5 of the presence of the Nutri-Score and its five categories on consumers’ perceived healthiness
6 perceptions and purchase intentions. Consumers in the EU took part in two online
7 experiments, in which they rated products from different categories, with or without Nutri-
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8 Scores, in terms of their perceived healthiness and purchase intentions. The presence of the
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9 Nutri-Score enabled respondents to assess the healthiness of products better; furthermore, it
10 offers the potential to boost sales of healthy products, without affecting sales of unhealthy
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11 products. Perceived healthiness mediates the relationship between Nutri-Score categories and
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12 purchase intentions, and focusing on the healthiness of products can give producers a
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13 competitive advantage, regardless of whether it is a manufacturer brand or a private label.

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14 These findings offer actionable insights for public policy makers and manufacturers; they also
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15 suggest the need to embrace the Nutri-Score as the standard front-of-pack label to help fight
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16 the increasing obesity pandemic.
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18 Keywords: Nutri-Score, front-of-pack label, healthy consumer behavior, perceived
19 healthiness, purchase intentions

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20 1. Introduction
21 As a global epidemic, obesity contributes to approximately 2.8 million deaths annually
22 (World Health Organization, 2017a), prompting growing considerations of the relationship
23 between nutrition and health (World Health Organization, 2004). Globally, governments seek
24 effective preventive actions, including efforts to make consumers’ healthier food choices
25 easier at the time of purchase (Nishida, Uauy, Kumanyika, & Shetty, 2004). That is, even
26 though product manufacturers are required to display nutritional information in a detailed
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27 nutrition box on the back of food packaging, this information is often difficult for consumers
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28 to read and understand (Kivets & Simonson, 2000). In contrast, front-of-pack (FOP) labels
29 provide more limited, simpler, more visible information about critical nutritional elements
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30 (World Health Organization, 2018). Consumers are more inclined to rely on simpler labels in
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31 their decision making (Becker, Bello, Sundar, Peltier, & Bix, 2015), so FOP labels represent a
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32 promising means to address the obesity epidemic (Nestle & Jacobsen, 2000).
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33 Among the several FOP labels developed in recent years, this research focuses on the
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34 Nutri-Score (NS), which provides a clear summary of key nutrients and aims to make
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35 comparisons across products easier for consumers, at a glance (Santé Publique France, 2018).
36 We seek to determine its impact on perceived healthiness and purchase intentions, in the
37 pursuit of three main research contributions. First, we take a consumer perspective and
38 specifically address the impact of the NS, rather than comparing it with other FOP nutrition
39 labels. When they are shopping, consumers mostly evaluate product healthiness according to
40 the different NS categories, not different FOP nutrition labels. In this sense, our research
41 offers strong practical relevance. Second, we consider how focusing on the healthiness of
42 products influences purchase intentions. The NS seems to offer the potential to boost sales of
43 healthy products, without affecting sales of unhealthy products, implying that manufacturers
44 of both healthy and unhealthy products could implement the NS. Third, with our novel
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45 perspective, we seek to link the impact of the NS to brand types and find that focusing on
46 product healthiness can help a firm gain a competitive advantage, regardless of whether it
47 uses a manufacturer brand or private label. With this evidence, various stakeholders can be
48 assured that NS offers the optimal FOP nutrition label; we recommend embracing it as the
49 standard.
50 1.1. Packaging
51 When products are largely homogeneous in their core attributes, manufacturers must
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52 attract consumers’ attention on the basis of other attributes (Clement, Kristensen, &
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53 Grønhaug, 2013), such as packaging. Packaging is crucial to purchasing processes; consumers
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use it at the point of purchase (De Pelsmacker, Geuens, & Van den Bergh, 2017), where more
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55 than 70% of purchase decisions take place (Nielsen, 2016; Point-Of-Purchase Advertising
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56 International, 2014). In particular, packaging can powerfully influence (un)healthy food
57 choices (Gutjar, Graaf, Palascha, & Jager, 2014; Hallez, Qutteina, Raedschelders, Boen, &
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58 Smits, 2020), with potential implications for obesity concerns. Furthermore, packaging can
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59 affect product perceptions, such as when displayed claims of health benefits on unhealthy
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60 food products exert negative effects on perceived healthfulness (Bialkova, Sasse, & Fenko,
61 2016).
62 Consumers who are more concerned about their health and the food they consume
63 attend more to and demand simpler product information and nutrition labels (Grunert, Wills,
64 & Fernandez-Celemin, 2010; Silayoi & Speece, 2007; Talati, Egnell, Hercberg, Julia, &
65 Pettigrew, 2019; World Health Organization, 2004). With appropriate product information,
66 consumers are better able to make careful, well-considered, sufficiently informed choices
67 (Coulson, 2006). Yet consumers do not always read all the product information on packaging
68 (e.g., nutrition box, ingredients), whether because they face time pressures or struggle to
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69 understand the meaning of the nutrition information (Bartels, Tillack, & Jordan Lin, 2018;
70 Graham, Orquin, & Visschers, 2012; Grunert et al., 2010; Sharf et al., 2012).
71 1.2. Front-of-pack labels
72 To meet the needs of the current market, which cites the increasing importance of
73 easier-to-understand product information (Gomez, Werle, & Corneille, 2017; Silayoi &
74 Speece, 2007), many countries require FOP labels, and several designs are currently in use
75 (Food and Agriculture Organization of the United Nation, 2016). Defined as "simplified
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76 information about the most important nutritional aspects and characteristics of food" (L’Abbé,
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77 McHenry, & Emrich, 2012), FOP labels represent a combined initiative of governments,
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product manufacturers, and retailers to direct consumers toward healthier food choices (World
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79 Health Organization, 2018). Labels on the front of packaging can help consumers choose
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80 healthier products because they provide product information at a glance (Hersey, Wohlgenant,
81 Arsenault, Kosa, & Muth, 2013; Van Kleef & Dagevos, 2015) and attract attention (Bialkova
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82 & Trijp, 2010). In turn, FOP labels offer the promise of reducing obesity and its associated
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83 chronic illnesses (European Heart Network, 2006; Institute of Medicine of the National
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84 Academies, 2010; Merrifield, 2007).
85 In their theoretical framework, Grunert and Wills (2007) propose dividing FOP labels
86 into two categories: (1) nutrient-specific indicators that provide detailed information (e.g.,
87 Dietary Reference Intakes, Multiple Traffic Light labels, Warning Symbols) (Grunert &
88 Wills, 2007; Ikonen, Sotgiu, Aydinli, & Verlegh, 2019; Temple, 2020) or (2) summary
89 indicators with an overall score of the nutritional quality of the product (e.g., Tick, Green
90 Keyhole, Choices, Health Star Rating, SENS, NuVal, NS) (Grunert & Wills, 2007; Ikonen et
91 al., 2019). Summary labels can appear on both more and less nutritional products, which
92 means that consumers who engage in very unhealthy eating habits are still confronted by them
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93 (Temple, 2020). However, by greatly simplifying nutritional quality into a single score, some
94 important information (e.g., salt for people with high blood pressure) is lost (Temple, 2020).
95 1.3. Nutri-Score
96 The NS is a summary, color-coded, graded FOP label (Grunert & Wills, 2007) that
97 shows a scale of five colors, from dark green to red. The NS combines positive characteristics
98 (i.e., fruit, vegetables and nuts, fiber, protein and rapeseed, walnut and olive oils content) with
99 negative characteristics (i.e., energy, total sugar, saturated fatty acids and sodium content) to
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100 achieve a score between -15 (most healthy) and +40 (least healthy) (Julia & Hercberg, 2017a).
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101 As Figure 1 shows, this score is reduced to a combination of a letter (A to E) and a color
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(from dark green to red), where A reflects the highest nutritional quality and E the lowest
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103 (Julia & Hercberg, 2017b). The central, yellow category C helps discourage dichotomous
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104 thinking (Julia & Hercberg, 2017a).

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105
106 Figure 1. Nutri-Score label
107 The NS is not a substitute for the detailed nutrition box, which remains legally
108 required (European Commission, n.d.). Instead, it provides a way to simplify complex
109 nutrition information (World Health Organization, 2017b) and thereby guide or steer
110 consumers toward healthier purchasing choices (Julia & Hercberg, 2017b), as well as
111 incentivize manufacturers to improve the nutritional composition of their products (Santé
112 Publique France, 2018; Vyth, Steenhuis, Roodenburg, Brug, & Seidell, 2010).
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113 It has been officially recommended in several European countries (e.g., France,
114 Belgium, Spain), reflecting their health authorities’ belief that the NS can help them
115 counteract the obesity epidemic (Flemish Institute for Healthy Living, 2018). The European
116 Commission currently supports implementation on a voluntary basis (Julia & Hercberg,
117 2017a), though proponents, including retail and food industry giants such as Nestlé, Danone,
118 Ahold Delhaize, and Carrefour, have expressed support for a standard that makes the NS the
119 only FOP nutrition label for the entire European Union (Flemish Institute for Healthy Living,
120 n.d.; The European Consumer Organisation, 2020). Recognition of a single, reliable FOP
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121 label at the European level can help avoid a situation in which manufacturers of unhealthy
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122 products continue to fail to inform consumers about the sugar or fat in their products
123 (Foodwatch, 2018).

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124 In response to these developments, researchers have begun to investigate perceptions
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125 and understanding of the NS. Many studies compare it with other FOP nutrition labels,
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126 showing that the NS is the easiest to identify, requires the least time to understand across
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127 different product categories (Ducrot et al., 2015a; Egnell, Talati, Hercberg, Pettigrew, & Julia,
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128 2018), and is the most preferred label (Julia et al., 2017). In addition, it appears to have the
129 greatest effect on consumers who lack nutritional knowledge, which represents a very
130 promising result (Ducrot et al., 2015b). According to Crosetto, Lacroix, Muller, and Ruffieux
131 (2018), consumers also tend to simplify even this already greatly simplified food label when
132 making food choices, by applying three “extreme” categories to define a product as good,
133 neutral, or bad. The five NS categories were defined deliberately to discourage dichotomous
134 thinking (Julia & Hercberg, 2017a), yet it appears that consumers make little distinction
135 between the healthiness of products with dark green and light green (A and B) labels or those
136 with orange and red (D and E) labels. Crosetto et al. (2018) argue that consumers behave as if
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137 there were only three categories. We test this claim among a sample of Flemish adults but also
138 consider how a simplified view of perceived healthiness might relate to purchase intentions.
139 In research that addresses the influence of the NS on purchase intentions and food
140 choices, it appears more effective in stimulating healthy food choices and improving the
141 nutritional quality of shopping baskets than other FOP labels (Crosetto et al., 2018; Flemish
142 Institute for Healthy Living, n.d.; Julia & Hercberg, 2017a; Poquet et al., 2019). Moreover,
143 the NS is the only label that led consumers to add products with significantly lower amounts
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144 of (saturated) fat and salt to their shopping carts (Ducrot et al., 2016). These findings suggest
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145 potentially higher purchase intentions for healthy products (A and B) and lower purchase
146 intentions for unhealthy products (D and E). We aim to determine if this difference in
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147 purchase intentions arises between products with or without NS and for all five NS categories.
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148 1.4. Branding

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149 Furthermore, the NS might have distinct effects for different brand types. Both private
150 labels and manufacturer brands have added the NS to their packaging, including Nestlé,
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151 Danone, Bonduelle, Alpro, Materne, and McCain, as well as prominent retailers in Belgium
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152 (Delhaize and Colruyt) and France (Intermarché, Auchan, Leclerc, and Carrefour) (Flanders
153 Today, 2018). We predict the potential for differential effects because consumers who mainly
154 buy manufacturer brands are very brand aware and usually prefer to buy as many branded
155 products as possible, which they value more (Goldsmith, Flynn, Goldsmith, & Stacey, 2010).
156 If prices increase, private label consumers tend to switch to alternatives more readily than
157 consumers who buy manufacturer brands, implying their lower brand loyalty (Goldsmith et
158 al., 2010). These findings lead us to predict that consumers who purchase private labels may
159 respond more strongly to seeing a NS than consumers who buy manufacturer brands, because
160 they are less brand loyal. In particular, the effect of the NS on purchase intentions may arise
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161 for both private labels and manufacturer brands, but because consumers are more loyal to the
162 latter, the effect may be stronger for private labels than for manufacturer brands.
163 To test these considerations and factors, we conduct two studies of the presence of the
164 NS and its different categories on perceived healthiness and purchase intentions for
165 (un)healthy food products. Furthermore, we check for any additional differences in perceived
166 healthiness and purchase intentions between manufacturer brands and private labels.
167 2. Study 1
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168 With Study 1, we test whether the presence of the NS influences perceived healthiness
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169 and purchase intentions, as well as whether the effects differ across NS categories.
170 2.1. Pretest

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To select equally attractive products for the main study, we conducted a pretest with
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172 52 respondents. In this within-subjects design, respondents rated the attractiveness of nine
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173 ready-to-eat meals on a 7-point semantic differential scale (1 = “very unattractive,” 7 = “very
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174 attractive”). To ensure some level of consistency, the nine products represented the same
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175 brand and had transparent packaging (Appendix A), but three of them would have scored A
176 on the NS, three were NS B meals, and three were NS C meals. We used exactly the same NS
177 labels as they appear on the products in the shops. That is, the NS did not appear on the
178 products, but with this pretest, we sought to select one meal from each NS category that
179 respondents considered equally attractive. Because most ready-to-eat meals earn NS of A, B,
180 or C (Vlaams Instituut Gezond Leven, 2018), we chose not to include D and E categories in
181 this study.
182 We conducted a repeated measures analysis of variance (ANOVA) with product
183 attractiveness as the dependent variable. In the within-subjects design, each participant rated
184 nine food products (Appendix B), which revealed three products, each from a different NS
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185 category, that were equally attractive. Mauchly’s test indicated a violation of the assumption
186 of sphericity (χ2(2) = 7.18, p = .028), so we corrected the degrees of freedom using Huynh-
187 Feldt estimates of sphericity (ε = .91). The results revealed no significant differences in
188 attractiveness across the products identified for category A (MA = 3.08, SD = 1.57), B (MB =
189 3.13, SD = 1.56), and C (MC = 3.23, SD = 1.49; F(1.82, 92.94) = .19, p = .807, η2 = .004), so
190 we include them in the main study.
191 2.2. Main study
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193 We recruited 303 respondents (62% women, Mage = 30.82 years, SD = 14.06) to
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participate in an online experiment. A research assistant recruited a convenience sample of
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195 respondents in Flanders–one of the first regions in which the NS was introduced, and with an
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196 awareness of 91% the NS is very well known among the Flemish population (Test Aankoop,
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197 2020)–using announcements on various social media, emails, and general recruitment
198 platforms of a university. The research assistant was instructed to sample different age ranges
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199 (Appendix E), women and men, and people with different education levels. We included an
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200 attention check to ensure the robustness of the results (Kung, Kwok, & Brown, 2018). Eleven
201 respondents failed the attention check, so we eliminated them from further analysis. A total of
202 292 respondents (61% women, Mage = 30.37 years, SD = 14.01) remained for further analysis.
203 Each participant saw a picture of one of the three ready-to-eat meals selected in the
204 pretest, accompanied with its NS or not (Appendix A). Thus we developed a 3 (NS category:
205 A vs. B vs. C) × 2 (NS: present vs. not present) between-subjects design. The respondents
206 were randomly assigned to one of the six conditions and asked to rate the product on several
207 rating scales, presented in a random order. Perceived healthiness was measured on a 7-point
208 semantic differential scale (Adams & Geuens, 2007), anchored by “unhealthy–healthy,” “low
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209 in fat–high in fat,” “low in calories–high in calories,” “low in vitamins–high in vitamins,” and
210 “not nutritious–nutritious” (α = .82). After recoding the second and third items, we averaged
211 these scores to obtain a general perceived healthiness score. To measure purchase intentions,
212 we used a 7-point Likert scale (Baker & Churchill, 1977), composed of four items: “I would
213 buy this product when I see it in the store,” “I would consider this product when I intend to
214 buy a ready-to-eat meal,” “I would like to test this product,” and “I will buy this product in
215 the store” (α = .93). Perceived tastiness was measured on a 7-point Likert scale composed of
216 “This product has a good taste,” “This product makes me hungry,” “This product tastes
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217 great,” “This product has a pleasant texture,” and “This product makes me want to eat” (α =
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218 .91). For perceived quality, respondents indicated, on a 7-point semantic differential scale,
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their overall rating of the product (1 = “very low quality,” 7 = “very high quality”).
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220 2.2.2. Results
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221 Perceived quality. In a 3 × 2 between-subjects ANOVA with perceived quality as the

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222 dependent variable and age included as a covariate, we found no significant main effect of the
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223 presence of the NS on perceived quality (F(1, 285) = 1.58, p = .691, η2 = .00) but a significant
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224 main effect of the NS category (F(2,285 = 3.44, p = .033, η2 = .02). Age related significantly
225 to perceived quality too (F(1, 285) = 5.76, p = .017, η2 = .02). Figure 2 reveals the significant
226 interaction between NS presence and NS category (F(2, 285) = 3.36, p = .036, η2 = .02), such
227 that a product in category C (MC-NS = 3.40, SD = 1.10) evoked lower quality perceptions than
228 products in category A (MA-NS = 4.17, SD = 1.11, p = .002) or B (MB-NS = 3.97, SD = 1.07, p =
229 .022), but only when the NS was present. For a product in category A, the presence of the NS
230 led to marginally significantly higher perceptions of quality than if the NS was not present
231 (MA-NoNS = 3.79, SD = 1.05, p = .074). For a product in category C, it produced marginally
232 significantly lower perceptions of quality than if the NS was not present (MC-NNS = 3.77, SD =
233 1.02, p = .075).

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Nutri-Score Category
Nutri-Score present Nutri-Score not present
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235 Figure 2. Interaction effect of NS presence and NS category on perceived quality
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Perceived tastiness. To check whether a NS influences perceived tastiness, we
conducted another 3 × 2 between-subjects ANOVA with perceived tastiness as the dependent

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238 variable and age as a covariate again. We found no significant main effect of NS presence
239 (F(1, 285) = .05, p = .820, η2 = .00) or NS category (F(2, 285) = 1.58, p = .208, η2 = .01) on
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240 perceived tastiness, nor did age related significantly to this outcome (F(1, 285) = 2.50, p =
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241 .115, η2 = .01). Finally, no significant interaction arose between NS presence and NS category
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242 (F(2, 285) = 1.25, p = .287, η2 = .01).
243 Perceived healthiness. In the 3 × 2 between-subjects ANOVA with perceived
244 healthiness as the dependent variable and age as a covariate, we found significant main effects
245 of both NS presence (F(1, 285) = 11.42, p = .001, η2 = .04) and NS category (F(2, 285) =
246 17.10, p < .001, η2 = .11) on perceived healthiness. The covariate age was not significantly
247 related to perceived healthiness (F(1, 285) = 2.61, p = .108, η2 = .01). Figure 3 also indicates a
248 marginally significant interaction between NS presence and NS category (F(2, 285) = 2.50, p
249 = .084, η2 = .02). When a NS was present, respondents perceived products as healthier,
250 though only for products in category A (MA-NS = 4.40, SD = 1.29; MA-NNS = 3.73, SD = 1.29, p
251 = .002) or B (MB-NS = 3.70, SD = .84; MB-NNS = 3.22, SD = .94, p = .015). Furthermore,
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252 products in category A appeared healthier than those in categories B and C (MC-NS = 3.23, SD
253 = .92, p < .001), and those in category B seemed marginally significantly healthier than
254 products in category C (p = .079). Without an NS, the results indicate that products in
255 category A were considered healthier than products in category B (p = .033) or C (MC-NNS =
256 3.20, SD = .78, p = .039).
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258 Figure 3. Interaction effect of NS presence and NS category on perceived healthiness

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259 Purchase intentions. The 3 × 2 between-subjects ANOVA with purchase intention as

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260 the dependent variable and age as a covariate revealed no significant main effect of NS
261 presence on purchase intentions (F(1, 285) = .01, p = .920, η2 = .00). Instead, we found a
262 marginally significant main effect of NS category on purchase intentions (F(2, 285) = 2.58, p
263 = .078, η2 = .02), as well as a significant relation of age (F(1, 285) = 4.39, p = .037, η2 = .02).
264 No significant interaction emerged between NS presence and NS category (F(2, 285) = .83, p
265 = .439, η2 = .01). A product in category A (MA-NS = 3.49, SD = 1.68) evoked stronger purchase
266 intentions than a product in category C (MC-NS = 2.71, SD = 1.38; p = .045) but only if the NS
267 was present.
268 2.2.3. Mediation analyses

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269 We also sought to determine whether perceived healthiness mediates the relationship
270 between NS category and purchase intentions. For our three NS category conditions, we
271 created two dummy variables: one to compare categories A and C (Dummy A: NS A = 1, NS
272 B = 0, NS C = 0) and one to compare categories B and C (Dummy B: NS A = 0, NS B = 1,
273 NS C = 0). In a mediation analysis with purchase intentions as the dependent variable,
274 Dummy A is the independent variable, and Dummy B represents a covariate, with perceived
275 healthiness as the mediator. We found a significant positive effect of NS category on purchase
276 intentions (B = .78, SE = .31, t(145) = 2.52, p = .013). To test the underlying process, we use
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277 bias-corrected bootstrapping and generate a 95% confidence interval (CI) around the indirect
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278 effect of perceived healthiness; evidence of mediation exists if the CI excludes 0 (Hayes,
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2017). The analysis (10,000 bootstrap samples; bias-corrected CIs) revealed a significant
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280 indirect mediation effect (ab = .71, SE = .21; 95% lower level CI [LLCI] = .354, 95% upper-
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281 level CI [ULCI] = 1.191). As predicted, NS A (vs. NS C) increased perceived healthiness,

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282 which subsequently increased purchase intentions (Figure 4).

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283 In a similar mediation analysis with purchase intentions as the dependent variable and
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284 perceived healthiness as a mediator, Dummy B becomes the independent variable, and
285 Dummy A is a covariate. We found no significant total effect of NS category on purchase
286 intentions (B = .43, SE = .31, t(145) = 1.40, p = .163), but the bias-corrected CIs revealed a
287 significant indirect mediation effect (ab = .28, SE = .13; 95% LLCI = .073, 95% ULCI =
288 .585) (Mackinnon, Krull, & Lockwood, 2000; Zhao, Lynch, & Chen, 2010). As predicted, NS
289 B (vs. NS C) increased perceived healthiness and thus purchase intentions (Figure 4).
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291 Figure 4. Effect of NS categories A and B on purchase intentions via perceived healthiness
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292 3. Study 2
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293 With Study 1, we determine that the NS had a positive effect on perceived quality,
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294 perceived healthiness, and purchase intentions. The respondents also seemed to distinguish
295 the perceived healthiness of NS A versus NS B, without any effect on perceived tastiness.
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296 Notably, we found no trade-off between quality and healthiness. However, Study 1 has some
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297 limitations. First, it only includes the NS categories A, B, and C. Second, the between-
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298 subjects design is not realistic; in actual shopping situations, consumers choose among
299 different options. Therefore, we include NS categories D and E and use a mixed design in
300 Study 2 to test if the presence of the NS influences perceived healthiness across all five NS
301 categories. In addition, we investigate whether its presence results in higher purchase
302 intentions for healthy products and lower purchase intentions for unhealthy products. That is,
303 does the presence of the NS stimulate healthier choices? Finally, with Study 2 we aim to
304 investigate whether the effects differ for manufacturer brands versus private labels.
305 3.1. Method

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306 We recruited 441 respondents (69% women, Mage = 37.66 years, SD = 14.89) to
307 participate in an online study. As in the previous study, respondents were recruited in
308 Flanders, as a convenience sample (Appendix E). The study was announced on various social
309 media, emails, and general recruitment platforms of the university. Twenty-six respondents
310 responded incorrectly to the attention check, so we eliminated them from further analysis. A
311 total of 415 respondents (69% women; Mage = 37.28 years, SD = 14.93) remained for further
312 analysis.
The 2 (NS: present vs. not present) × 2 (brand: manufacturer brand vs. private label)
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314 mixed design includes repeated measures for the NS category. Each participant was randomly
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assigned to one of four conditions (between-subjects factor). Then in each condition,
316 respondents saw four products per NS category, for a total of 20 product pictures (within-
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317 subjects factor), shown in a random order. For each NS category, we selected four
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318 manufacturer branded products and four private-label products. Specifically, we selected
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319 manufacturer brands, then searched for a private label that posted the same NS and also
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320 offered comparable packaging to the manufacturer brand’s. With this matching process, we
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321 limited any influences of other packaging elements (e.g., color, shape). To ensure appropriate
322 links, we checked that the NS appeared on all products; if not, we calculated the score and
323 added it. Thus, we derived 20 best matches (Appendix C), across the cookies, dairy products,
324 preserves and sauces, and non-alcoholic drinks categories. Perceived healthiness and purchase
325 intentions are the dependent variables, such that respondents rated each food item on these
326 two scales, presented in a random order. We measured perceived healthiness on a 7-point
327 semantic differential scale (1 = “unhealthy,” 7 = “healthy”). For purchase intentions, we used
328 a 7-point Likert scale with three items: “I will buy this product,” “Next time I am buying a
329 [product category], I will choose this product,” and “I prefer this product to other [product
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330 category]” (Mai & Hoffmann, 2015). The internal consistency (Cronbach’s alpha) of this
331 scale ranges from .89 to .96 for all 20 products.
332 After evaluating the 20 products, respondents answered general questions about their
333 subjective nutritional knowledge, the importance of healthy food, dieting behavior, and
334 familiarity with the NS prior to this study. Consumers with more nutritional knowledge are
335 better able to understand and correctly interpret food labels (Wardle, Parmenter, & Waller,
336 2000), and they include nutrition labels more often in their decision-making process
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337 (Drichoutis, Lazaridis, & Nayga, 2005; Grunert et al., 2010). To measure subjective
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338 nutritional knowledge, we used a 7-point Likert scale with seven items: “I have quite a bit of
339 knowledge about food and beverages,” “Within my group of friends, I am one of the experts
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340 in food and beverages,” “I don't often come across new information about food and beverages
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341 that I did not know about,” “Compared to others, I have little knowledge about food and
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342 beverages,” “I am up to date with the most up-to-date information on food and beverages,” “I
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343 don't feel well informed about food and beverages,” and “I know quite a bit about food and
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344 beverages” (α = .87) (Flynn & Goldsmith, 1999). The fourth and sixth items were reversed.
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345 We measured perceptions of the importance of healthy food because consumers who are more
346 motivated to eat healthy tend to look at all available nutritional information (Turner, Skubisz,
347 Pandya, Silverman, & Austin, 2014) and make more use of food labels (Hess, Visschers, &
348 Siegrist, 2012) to search for healthier alternatives within a product range (Petrovici & Ritson,
349 2006). For this measure, we used a 7-point Likert scale with five items: “Every time I buy a
350 food product, I check the nutritional information,” “I generally try to eat and drink food
351 products with a low fat and sugar content,” “I usually feel guilty if I eat or drink fat or sugar,”
352 “I keep a close eye on the type of products I eat and drink,” and “I practice sports” (α = .71)
353 (Desai & Ratneshwar, 2003). Dieting behavior is another important covariate, in that
354 consumers who indicate that they restrict their diets also tend to use nutrition labels more
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355 (Ollberding, Wolf, & Contento, 2011; Soederberg Miller et al., 2015). To measure this
356 behavior, we used a 7-point Likert scale with three items: “I try to lose weight by eating less,”
357 “I choose food that is low in fats because I am trying to lose weight,” and “I am currently
358 watching my food to lose weight” (α = .84) (Lowe, 1993). The last covariate is familiarity
359 with the NS; familiarity helps people understand the labels, enhances their trust in them, and
360 thus increases their usage during decision making (Grunert et al., 2010; Van Herpen, Seiss, &
361 Van Trijp, 2012). We used a 7-point semantic differential scale and three items: “I was not–
362 was familiar with the Nutri-Score,” “I didn't recognize–recognized the Nutri-Score,” and “I
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363 hadn't heard—had heard of the Nutri-Score” (α = .88) (Kumar, 2005).
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365 3.2.1. Perceived healthiness
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366 Because the data comprise information about multiple stimuli, viewed by each
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367 participant, we need a multilevel analysis to account for the hierarchical data structure (Bryk
368 & Raudenbush, 1992; Snijders & Bosker, 1999). Perceived healthiness is the dependent
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369 variable, and NS presence (present vs. not present) and NS category (A, B, C, D and E) serve
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370 as the independent variables. Subjective nutritional knowledge, importance of healthy food,
371 dieting behavior, familiarity with the NS, and age are included as covariates. To account for
372 participant-level effects, we randomly estimated the intercept. In the intercept-only model, the
373 intraclass correlation coefficient (ICC) was .05, and it yielded a –2 restricted log-likelihood
374 value (−2LL) of 34404.66. However, model fit improved significantly for a fixed-effects
375 multilevel model with a random intercept estimation for each participant (–2LL = 29570.63;
376 Δχ2 = 4834.03, Δdf = 14, p < .001). This model indicated a significant difference in perceived
377 healthiness across the NS presence (F(1, 408) = 4.75, p = .030) and NS category (F(4, 7877)
378 = 1674.37, p < .001) conditions, after controlling for the effects of subjective nutritional
379 knowledge, importance of healthy food, dieting behavior, familiarity with the NS, and age.
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380 Both importance of healthy food (F(1, 408) = 6.51, p = .011) and age (F(1, 408) = 24.75, p <
381 .001) related significantly to perceived healthiness, whereas familiarity with the NS (F(1, 409)
382 = .39, p = .534), subjective nutritional knowledge (F(1, 409) = .06, p = .805), and dieting
383 behavior (F(1, 409) = .29, p = .588) did not. In Figure 5, we also note the significant
384 interaction between NS presence and NS category (F(4, 7877) = 15.51, p < .001).
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386 Figure 5. Interaction effect of NS presence and NS category on perceived healthiness

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387 When the NS was present, products in categories A (MA-NS = 5.91, SD = 1.48; p <
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388 .001) and B (MB-NS = 4.53, SD = 1.66; p < .001) evoked higher perceived healthiness than in
389 the NS not present condition (MA-NNS = 5.51, SD = 1.39; MB-NNS = 4.16, SD = 1.78); we found
390 no significant differences for products in categories C (MC-NS = 3.76, SD = 1.21; MC-NNS =
391 3.70, SD = 1.48; p = .353) or D (MD-NS = 2.97, SD = 1.42; MD-NNS = 3.11, SD = 1.40; p = .136)
392 though. A marginally significant difference in perceived healthiness arose between products
393 in category E, depending on whether the NS was present (ME-NS = 1.90, SD = 1.53; ME-NNS =
394 2.06, SD = 1.33; p = .085). As expected, all NS categories differed significantly from one
395 another, with p-values less than .001, when a NS was present as well as when it was not.
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396 Regarding the type of brands, we check these effects for manufacturer brands and
397 private labels. In a multilevel analysis, we found no significant three-way interaction among
398 NS presence, NS category, and brand type (F(4, 7885) = 1.70, p = .148). That is, the effects of
399 NS presence and NS category on perceived healthiness were the same for manufacturer
400 brands and private labels.
401 3.2.2. Purchase intentions
402 We again use a multilevel analysis to account for the hierarchical data structure (Bryk
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403 & Raudenbush, 1992; Snijders & Bosker, 1999). In this analysis, purchase intention is the
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404 dependent variable, NS (present vs. not present) and NS category (A, B, C, D and E), are
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independent variables, and the five covariates remain the same. To account for participant-
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406 level effects, we again randomly estimated the intercept. The intercept-only model indicated
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407 an ICC of .22, so about one-fifth of the variance occurs at the individual level. The –2LL was
408 31484.64, and model fit improved significantly when we ran a fixed-effects multilevel model
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409 with a random intercept estimation for each participant (−2LL = 31239.01; Δχ2 = 245.63, Δdf
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410 = 14, p < .001). Thus, we found a significant difference in purchase intentions across the NS
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411 presence (F(1, 408) = 5.44, p = .020) and NS category (F(4, 7877) = 58.55, p < .001)
412 conditions, after controlling for the effects of the covariates. The importance of healthy food
413 (F(1, 408) = 4.94, p = .027) and familiarity with the NS (F(1, 408) = 9.43, p = .002)
414 covariates related significantly to perceived healthiness, whereas subjective nutritional
415 knowledge (F(1, 408) = 1.77, p = .185) and dieting behavior (F(1, 408) = 1.46, p = .228) did
416 not, and age (F(1, 408) = 3.82, p = .051) was marginally significantly related to it. We depict
417 the significant interaction between NS presence and NS category (F(4, 7877) = 15.91, p <
418 .001) in Figure 6.

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420 Figure 6. Interaction effect of NS presence and NS category on purchase intention
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421 When a NS was present, respondents indicated significantly higher purchase intentions
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422 for products in categories A (MA-NS = 4.41, SD = 1.55, p < .001) and B (MB-NS = 3.86, SD =
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423 1.66, p < .001) than if no NS were present (MA-NNS = 3.92, SD = 1.61; MB-NNS = 3.35, SD =
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424 1.71). However, regardless of the presence of NS, no significant differences in purchase
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425 intentions emerged for products in categories C (MC-NS = 3.67, SD = 1.55; MC-NNS = 3.54, SD
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426 = 1.70, p = .203), D (MD-NS = 3.47, SD = 1.73; MD-NNS = 3.61, SD = 1.78, p = .235), and E
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427 (ME-NS = 3.43, SD = 1.93; ME-NNS = 3.45, SD = 1.89, p = .873). Without an NS, we identified
428 (marginally) significant differences between NS categories A and B (p < .001), A and C (p <
429 .001), A and D (p < .001), A and E (p < .001), B and C (p = .095), and B and D (p = .004). In
430 addition, with a NS, categories A and B (p < .001), A and C (p < .001), A and D (p < .001), A
431 and E (p < .001), B and D (p < .001), B and E (p < .001), C and D (p = .091), and C and E (p
432 = .013) differed significantly from each other (Appendix D).
433 We further check whether these effects differ between manufacturer brands and
434 private labels. With a multilevel analysis, we found that in general and as expected, products
435 of a manufacturer brand evoked stronger purchase intentions than products of a private label
436 (Mmanufacturerbrand = 4.06, SD = 1.76; Mprivatelabel = 3.23, SD = 1.61; F(1, 415) = 116.02, p <
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437 .001). However, there was no significant three-way interaction among NS presence, NS
438 category, and brand type (F(4, 7885) = .24, p = .915). The effects of NS presence and NS
439 category on purchase intentions were the same for manufacturer brands and private labels.
440 3.3. Mediation analyses
441 With a multilevel mediation model with a random intercept that accounts for the
442 hierarchical data structure (Bryk & Raudenbush, 1992; Hayes, 2017; Snijders & Bosker,
443 1999), we sought to determine whether perceived healthiness mediates the relationship
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444 between the NS category and purchase intention. For the five NS category conditions, we
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445 created four dummy variables to compare categories A and C (Dummy A; NS A = 1, all other
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NS = 0), B and C (Dummy B; NS B = 1, all other NS = 0), D and C (Dummy D; NS D = 1, all
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447 other NS = 0), and E and C (Dummy E; NS E = 1, all other NS = 0).
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448 In a first mediation analysis, purchase intention is the dependent variable, Dummy A
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449 serves as the independent variable, and Dummies B, D, and E are covariates; in addition,
450 perceived healthiness is a mediator. We found a significant positive effect of NS category on

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451 purchase intentions (B = .74, SE = .08, t(3739) = 9.82, p < .001). To test the underlying
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452 process, we used Monte Carlo methods to generate a 95% CI around the indirect effect of
453 perceived healthiness, such that mediation exists if the CI excludes 0 (Hayes & Rockwood,
454 2019). The analysis (10,000 simulations; Monte Carlo CI) revealed a significant indirect
455 mediation effect (ab = .59, SE = .04; 95% LLCI = .513, 95% ULCI = .674). As predicted, NS
456 A (vs. NS C) increased perceived healthiness, which then increased purchase intentions
457 (Figure 7).
458 A similar mediation analysis includes purchase intentions as the dependent variable,
459 perceived healthiness as a mediator, Dummy B as the independent variable, and Dummies A,
460 D, and E as covariates. It revealed a significant positive effect of NS category on purchase

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461 intentions (B = .19, SE = .08, t(3739) = 2.50, p = .012), and the Monte Carlo analysis
462 indicated a significant indirect mediation effect (ab = .21, SE = .02; 95% LLCI = .165, 95%
463 ULCI = .259). As predicted, NS B (vs. NS C) increased perceived healthiness, which
464 increased purchase intentions (Figure 7).
465 A third mediation analysis includes Dummy D as the independent variable and
466 Dummies A, B, and E as covariates, and it indicated a significant negative effect of NS
467 category on purchase intentions (B = -.20, SE = .08, t(3739) = -2.63, p = .009). The Monte
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468 Carlo CI affirmed a significant indirect mediation effect (ab = -.22, SE = .02; 95% LLCI = -
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469 .267, 95% ULCI = -.172). As predicted, NS D (vs. NS C) decreased perceived healthiness,
470 which made respondents less willing to purchase the product (Figure 7).
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471 Finally, when we use Dummy E as the independent variable and Dummies A, B, and
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472 D as covariates, we found a significant negative effect of NS category on purchase intentions
473 (B = -.24, SE = .08, t(3739) = -3.25, p = .001). The Monte Carlo CIs confirmed a significant
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474 indirect mediation effect (ab = -.52, SE = .04; 95% LLCI = -.588, 95% ULCI = -.440). As
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477
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478 Figure 7. Effect of NS A, B, D, and E on purchase intentions via perceived healthiness
479 4. General discussion
480 The presence of the NS helped the respondents in these studies assess the healthiness
481 of products more easily. Thus, the first objective of the NS—to make respondents more aware
482 of product healthiness—has been achieved; respondents identified healthy products as
483 healthier when the NS is present. In addition, they regarded the healthiness of products ranked
484 in five categories significantly differently. We did not find evidence that respondents thought
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486 (Crosetto et al., 2018), they could distinguish dark green (NS A) from light green (NS B)
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labeled products and orange (NS D) from red (NS E) ones, in terms of their perceived
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488 healthiness. In this respect, our findings are promising regarding the effectiveness of the NS,
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489 which was designed explicitly to support more nuanced, accurate assessments of products’
490 healthiness and to avoid dichotomous thinking (Julia & Hercberg, 2017a).
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491 Our studies also indicate that respondents expressed higher purchase intentions for
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492 products with a positive NS (A and B) than for products with a negative NS (D and E), as
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493 well as for healthy products that feature the NS rather than those without it. However, average
494 purchase intentions for unhealthy products were identical, whether the NS was present or not.
495 These findings resonate with previous research that shows that respondents are inclined to
496 choose more products with a green NS and fewer with a red NS (Crosetto et al., 2018; Ducrot
497 et al., 2015a). Thus, we showed that the NS has the potential to boost sales of healthy
498 products, while not affecting sales of unhealthy products. This interesting finding may
499 mitigate fears among food industry actors that the NS would have negative impacts on the
500 sales of red-labeled (NS E) products (Julia & Hercberg, 2018). For example, the federation of
501 the Belgian food industry has argued that the NS is too stigmatizing for some unhealthy
502 export products (e.g., chocolate in Belgium), which the country instead should be proud of
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503 (Fevia, 2018). Our results suggest the food industry does not need to worry about sales of
504 such products, even if they feature the NS.
505 Yet perceived healthiness did mediate the relationship between NS category and
506 purchase intentions. Because NS A and B increased the perceived healthiness of food
507 products, respondents in our study were more willing to purchase them than products with a
508 less good NS. Because NS D and E decreased their perceived healthiness, respondents were
509 less willing to purchase these food products than products with a better NS. In this sense, the
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511 healthier purchases.
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513 private labels (Underwood & Klein, 2002), we also sought to determine if such trust in
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514 manufacturer brands prevents the NS from functioning properly, but we did not find any
515 evidence of an effect of the type of brand on the relationships of the NS with either perceived
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516 healthiness or purchase intentions. In contrast, prior research shows that, in addition to their
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517 trust in its quality, consumers are less likely to find alternatives to a manufacturer branded
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518 product (Goldsmith et al., 2010; Harding & Quelch, 1996), which is why we predicted that the
519 NS might have less impact on manufacturer brands than on private labels (Elliott &
520 Yannopoulou, 2007; Goldsmith et al., 2010; Harding & Quelch, 1996). The lack of difference
521 that we found instead might imply that due to their rising quality, consumers largely accept
522 and trust in private labels, so they remain more loyal to them (Ailawadi & Keller, 2004; Calvo
523 Porral & Levy-Mangin, 2016; Nielsen, 2018), regardless of the presence of the NS.
524 4.1. Theoretical contributions
525 In addition to these findings, this investigation contributes specifically to academic
526 research into packaging. We extend prior research on packaging labels by clarifying their
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527 impact on critical consumer responses, including product perceptions and purchase intentions.
528 Our findings affirm that the NS has substantial implications for healthy food choices, in
529 support of prior calls for easier-to-understand product information on packaging (Silayoi &
530 Speece, 2007). With our detailed analysis, focused solely on the NS instead of comparisons
531 across FOP labels (Egnell et al., 2018; Julia et al., 2017; Talati et al., 2019), we provide a
532 better understanding of how the NS in particular affects perceived healthiness and purchase
533 intentions. As we show, consumers evaluate the healthiness of products according to the
534 different NS categories, not different FOP nutrition labels. Our study results also offer a new
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535 perspective, in that we link the impact of the NS to the type of brand and thus can demonstrate
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536 that identifying product healthiness can lead to a competitive advantage, for both
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538 research and a better understanding of how product manufacturers and public policy makers
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539 can encourage healthy food choices through packaging.

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541 To date, the NS label has been implemented only on a voluntary basis in France,
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542 Belgium, and Spain, and its adoption mainly has involved a few, important actors in the food
543 retail market (e.g., Danone, Alpro). The limited spread of the NS prevents consumers from
544 making accurate comparisons across products, but considering our findings that respondents
545 make healthier food choices when it is present, its mandatory implementation for all food
546 products in Europe seems appropriate and could have beneficial consequences for retailers,
547 manufacturers, consumers, nutritionists, other stakeholders, and public policy makers.
548 The NS and its associated transparency could help retailers and manufacturers attract
549 consumers. Including it on their product packaging would signal that they care about the
550 health of their customers and increase customer trust. Acknowledging product healthiness
551 with a rating, even if the products are relatively unhealthy, establishes a competitive
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552 advantage for manufacturer and retailer private-label brands. Therefore, the findings should
553 encourage both retailers and manufacturers to place the NS on all their products. This
554 recommendation may be particularly relevant for manufacturers of unhealthy brands, which
555 might hesitate to use it, for fear that consumers will switch to healthier alternatives (Julia &
556 Hercberg, 2018). However, our research showed that the presence of the NS does not reduce
557 purchase intentions of unhealthy products, a benefit that should be communicated clearly to
558 manufacturers. The mandatory introduction of the NS would offer them a viable solution to
559 meet demands for simple FOP labels for food (Talati et al., 2019). Sales of healthy foods
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560 grow when FOP labels are applied to all products within a category, rather than just a
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561 selection of healthy options (Rahkovsky, Lin, Lin, & Lee, 2013; Sacks, Rayner, & Swinburn,
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2009; Sutherland, Kaley, & Fischer, 2010). If manufacturers must display the NS on their
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563 product packaging, they also might seek to improve product compositions to achieve the best
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564 possible NS for their product, compared with direct competitors. In this way, this research
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565 highlights the viability of another important objective of the NS, namely, to motivate
566 manufacturers to maximize the nutritional quality of their products (Vyth et al., 2010).
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567 Consumers also benefit. They often feel overwhelmed by the vast product options in a
568 supermarket or confused by various FOP labels (Draper et al., 2013). If the NS became
569 compulsory on all packaging, consumers could easily compare food products, regardless of
570 brand type, and make healthier choices. Such an implementation also would grant consumers
571 more confidence in the NS, such that they may be more inclined to follow its advice.
572 Finally, this research offers further evidence for public policy makers to use to
573 encourage or mandate the implementation of the NS. With such incentives to introduce the
574 NS on a larger scale, they could improve their efforts to tackle the obesity epidemic and
575 associated chronic diseases. Although the NS is a worthy candidate to be the sole, mandatory
576 European food label, some nuance also is appropriate here. It has some limitations, such as
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577 ignoring the extent to which products have been processed, their preparation method, or the
578 use of additives (Diet Sensor, 2018; Monteiro et al., 2016). Comparing the NS across different
579 product categories also might lead to incorrect interpretations. These points for consideration
580 do not outweigh the many benefits of the NS, yet governments still have the crucial task of
581 informing stakeholders about these limitations and guiding them with regard to how to make
582 optimal use of the NS, through information campaigns.
583 4.3. Limitations and further research
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584 A few limitations of this research suggest avenues for continued studies. First, we
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585 focused on five product categories, so our findings arguably may have limited generalizability
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to other product categories. The product categories we tested were relatively diverse, but
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587 further research could expand the analysis to an even greater scale, and with more or other
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588 product categories, to increase the generalizability of the findings.

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589 Second, all the studies were conducted online, whereas product evaluations tend to be
590 more informed when consumers can touch the product (Peck & Childers, 2003). Studies of
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591 the impact of the NS in an offline environment with real products would help consumers
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592 better imagine buying the product; studies in a real supermarket environment also might
593 determine actual purchases instead of gathering self-reported measures.
594 Third, our online studies also rely on data gathered from a single moment in time, so
595 we can only assess one-time evaluations. Additional research might consider more long-term
596 effects and investigate whether they persist after consumers become used to the NS.
597 Fourth, both studies involved a single, European country. Healthiness perceptions,
598 purchase intentions, subjective nutritional knowledge, importance of healthy food, dieting
599 behavior, and familiarity with the NS all vary across countries, as do obesity rates and the
600 relative prices of healthy and unhealthy food. Therefore, the impact of NS categories on
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601 perceived healthiness and purchase intentions likely differs in other countries, and research
602 that seeks to replicate our findings across countries is necessary. The impact of the NS has
603 been demonstrated in France (Julia & Hercberg, 2017b); we anticipate that our findings will
604 hold in other European countries and Western nations as well.
605 Fifth, our convenience sample of mainly younger adults is not necessarily
606 representative of the general population; middle-aged and younger adults are more likely to
607 use nutrition labels than older adults (Campos, Doxey, & Hammond, 2011). To address this
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608 issue, researchers should seek representative samples of general populations, with
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609 representation of mature families and older adults of both sexes. Such efforts could offer
610 further, more nuanced insights into the impact of the NS on product perceptions and purchase
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612 5. Conclusions
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613 In summary, respondents better assessed the healthiness of products when they saw
614 the NS, and they did not simplify it further, according to findings showing that respondents
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615 perceived the healthiness of products in each of the five NS categories significantly
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616 differently. In turn, respondents indicated significantly higher purchase intentions for healthy
617 products when the NS was present (vs. not present), yet no differences in purchase intentions
618 for unhealthy products when it was present. Finally, perceived healthiness mediated the
619 relationship between the presence of the NS and purchase intentions. We hope these findings
620 contribute to greater conviction among all stakeholders, to introduce the NS as the only
621 European FOP nutrition label and an effective option for addressing the growing obesity
622 epidemic.
623 Acknowledgments
624 The authors thank Tilien Vanhooren for help with the data collection for Study 1.
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625 Disclosure statement
626 This study obtained ethics approval from the Ethics Committee of the Faculty of
627 Economics and Business Administration of Ghent University.
628 Funding
629 This research did not receive any specific grant from funding agencies in the public,
630 commercial, or not-for-profit sectors.
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631 Appendix A
632 A1. Stimuli used in Study 1, pretest
A–1 A–2 A–3
B–1 B–2 B–3
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633 A2. Stimuli used in Study 1, main study
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635 Appendix B
636 Mean differences for the products in the pretest using a Bonferroni correction.
Product M SD A–1 A–2 A–3 B–1 B–2 B–3 C–1 C–2 C–3
A–1 5.29 1.30 1 1.77* 2.21* 2.15* 2.35* 2.46* 2.67* 1.15* 2.06*
A–2 3.52 1.41 1 .44 .39 .58 .69 .90* -.62 .29
A–3 3.08 1.57 1 -.06 .14 .25 .46 -1.06* -.15
B–1 3.13 1.56 1 .19 .31 .52 -1.00* -.10
B–2 2.94 1.46 1 .12 .33 -1.19* -.29
B–3 2.83 1.34 1 .21 -1.31* -.40
C–1 2.62 1.51 1 -1.52* -.62
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C–3 3.23 1.49 1
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639 Appendix C
Manufacturer brand Private label
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643
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644
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645 Appendix D
646 Mean differences in purchase intentions for different NS categories using a Bonferroni
647 correction.
M SD A B C D E
NS present
A 4.41 1.55 1 .55** .74** .94** .99**
B 3.86 1.66 1 .19 .39** .43**
†
C 3.67 1.55 1 .20 .25*
D 3.47 1.73 1 .05
E 3.43 1.93 1
of
NS not present
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A 3.92 1.61 1 .57** .38** .31** .47**
B 3.35 1.71 1 -.19† -.26* -.01
C 3.54 1.70
-p 1 -.07 .09
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D 3.61 1.78 1 .16
E 3.45 1.89 1
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648 † p < .100; * p < .050; ** p < .001.

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649
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650 Appendix E
651 Characteristics of the respondents in Study 1 and Study 2.
Study 1 (N = 292) Study 2 (N = 415)

Age categories
< 25 years N = 162 N = 114
25 – 35 years N = 51 N = 97
36 – 50 years N = 44 N = 106
> 50 years N = 35 N = 98
Education
of
Student N = 143
Blue collar worker N = 24
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White collar worker N = 110 Not measured in this study.
Retired
Unemployed
-p
N=4
N = 11
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Employment
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Primary education or no education N=7

Secondary education N = 105
Not measured in this study.
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Bachelor N = 108
Master N = 72
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652
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Appendix B
Mean differences for the products in the pretest using a Bonferroni correction.
Product M SD A–1 A–2 A–3 B–1 B–2 B–3 C–1 C–2 C–3
A–1 5.29 1.30 1 1.77* 2.21* 2.15* 2.35* 2.46* 2.67* 1.15* 2.06*
A–2 3.52 1.41 1 .44 .39 .58 .69 .90* -.62 .29
A–3 3.08 1.57 1 -.06 .14 .25 .46 -1.06* -.15
B–1 3.13 1.56 1 .19 .31 .52 -1.00* -.10
B–2 2.94 1.46 1 .12 .33 -1.19* -.29
B–3 2.83 1.34 1 .21 -1.31* -.40
C–1 2.62 1.51 1 -1.52* -.62
of
C–2 4.13 1.37 1 .90
ro
C–3 3.23 1.49 1
* p < .050. -p
re
lP
na
ur
Jo
Appendix D
Mean differences in purchase intentions for different NS categories using a Bonferroni

correction.
M SD A B C D E
NS present
A 4.41 1.55 1 .55** .74** .94** .99**
B 3.86 1.66 1 .19 .39** .43**
†
C 3.67 1.55 1 .20 .25*
D 3.47 1.73 1 .05
E 3.43 1.93 1
of
NS not present
ro
A 3.92 1.61 1 .57** .38** .31** .47**
B 3.35 1.71 1 -.19† -.26* -.01
C 3.54 1.70
-p 1 -.07 .09
re
D 3.61 1.78 1 .16
E 3.45 1.89 1
lP
† p < .100; * p < .050; ** p < .001.

na
ur
Jo
Appendix E
Characteristics of the respondents in Study 1 and Study 2.
Study 1 (N = 292) Study 2 (N = 415)

Age categories
< 25 years N = 162 N = 114
25 – 35 years N = 51 N = 97
36 – 50 years N = 44 N = 106
> 50 years N = 35 N = 98
Education
of
Student N = 143
Blue collar worker N = 24
ro
White collar worker N = 110 Not measured in this study.
Retired
Unemployed
-p
N=4
N = 11
re
Employment
lP
Primary education or no education N=7

Secondary education N = 105
Not measured in this study.
na
Bachelor N = 108
Master N = 72
ur
Jo
Figure 1. Nutri-Score label
of
ro
-p
re
lP
na
ur
Jo
7
6.5
6
5.5
Perceived Quality
5
4.5
4
3.5
3
2.5
2
1.5
1
A B C
of
Figure 2. Interaction effect of NS presence and NS category on perceived quality
ro
-p
re
lP
na
ur
Jo
7
6.5
6
5.5
5
4.5
4
3.5
3
2.5
2
1.5
1
A B C
of
Figure 3. Interaction effect of NS presence and NS category on perceived healthiness
ro
-p
re
lP
na
ur
Jo
of
Figure 4. Effect of NS categories A and B on purchase intentions via perceived healthiness
ro
-p
re
lP
na
ur
Jo
7
6.5
6
5.5
5
4.5
4
3.5
3
2.5
2
1.5
1
A B C D E
of
Figure 5. Interaction effect of NS presence and NS category on perceived healthiness
ro
-p
re
lP
na
ur
Jo
7
6.5
6
Purchase Intention
5.5
5
4.5
4
3.5
3
2.5
2
1.5
1
A B C D E
of
Figure 6. Interaction effect of NS presence and NS category on purchase intention
ro
-p
re
lP
na
ur
Jo
of
ro
Figure 7. Effect of NS A, B, D, and E on purchase intentions via perceived healthiness
-p
re
lP
na
ur
Jo
Figures Appendix A1
of
ro
-p
re
lP
na
ur
Jo
Jo
ur
na
lP
re
-p
ro
of
Figures Appendix A2
of
ro
-p
re
lP
na
ur
Jo
Figures Appendix C
of
ro
-p
re
lP
na
ur
Jo
Jo
ur
na
lP
re
-p
ro
of
Jo
ur
na
lP
re
-p
ro
of
Jo
ur
na
lP
re
-p
ro
of
Jo
ur
na
lP
re
-p
ro
of
Jo
ur
na
lP
re
-p
ro
of
Jo
ur
na
lP
re
-p
ro
of
Jo
ur
na
lP
re
-p
ro
of

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Joyce De Temmerman, Eva Heeremans, Hendrik Slabbinck, Iris Vermeir

To appear in: Appetite

Received Date: 14 January 2020

© 2020 Elsevier Ltd. All rights reserved.

competitive advantage, regardless of whether it is a manufacturer brand or a private label.

the increasing obesity pandemic.

Healthiness and Purchase Intentions

Joyce De Temmerman,* Eva Heeremans, Hendrik Slabbinck, Iris Vermeir

Faculty of Economics and Business Administration, Ghent University, Tweekerkenstraat 2,

9000 Ghent, Belgium

Declarations of interest: none

13 competitive advantage, regardless of whether it is a manufacturer brand or a private label.

16 the increasing obesity pandemic.

18 Keywords: Nutri-Score, front-of-pack label, healthy consumer behavior, perceived

19 healthiness, purchase intentions

21 As a global epidemic, obesity contributes to approximately 2.8 million deaths annually

22 (World Health Organization, 2017a), prompting growing considerations of the relationship

26 though product manufacturers are required to display nutritional information in a detailed

56 International, 2014). In particular, packaging can powerfully influence (un)healthy food

71 1.2. Front-of-pack labels

84 Academies, 2010; Merrifield, 2007).

104 thinking (Julia & Hercberg, 2017a).

123 (Foodwatch, 2018).

148 1.4. Branding

170 2.1. Pretest

181 this study.

182 We conducted a repeated measures analysis of variance (ANOVA) with product

190 we include them in the main study.

191 2.2. Main study

221 Perceived quality. In a 3 × 2 between-subjects ANOVA with perceived quality as the

233 1.02, p = .075).

Nutri-Score present Nutri-Score not present

conducted another 3 × 2 between-subjects ANOVA with perceived tastiness as the dependent

242 (F(2, 285) = 1.25, p = .287, η2 = .01).

243 Perceived healthiness. In the 3 × 2 between-subjects ANOVA with perceived

256 3.20, SD = .78, p = .039).

Nutri-Score present Nutri-Score not present

258 Figure 3. Interaction effect of NS presence and NS category on perceived healthiness

259 Purchase intentions. The 3 × 2 between-subjects ANOVA with purchase intention as

267 was present.

268 2.2.3. Mediation analyses

272 B = 0, NS C = 0) and one to compare categories B and C (Dummy B: NS A = 0, NS B = 1,

281 level CI [ULCI] = 1.191). As predicted, NS A (vs. NS C) increased perceived healthiness,

282 which subsequently increased purchase intentions (Figure 4).

285 Dummy A is a covariate. We found no significant total effect of NS category on purchase

305 3.1. Method

331 scale ranges from .89 to .96 for all 20 products.

Nutri-Score present Nutri-Score not present

386 Figure 5. Interaction effect of NS presence and NS category on perceived healthiness

400 brands and private labels.

401 3.2.2. Purchase intentions

414 covariates related significantly to perceived healthiness, whereas subjective nutritional

418 .001) in Figure 6.

Nutri-Score present Nutri-Score not present

432 = .013) differed significantly from each other (Appendix D).

440 3.3. Mediation analyses

450 perceived healthiness is a mediator. We found a significant positive effect of NS category on

457 (Figure 7).

460 D, and E as covariates. It revealed a significant positive effect of NS category on purchase

463 ULCI = .259). As predicted, NS B (vs. NS C) increased perceived healthiness, which

464 increased purchase intentions (Figure 7).

466 Dummies A, B, and E as covariates, and it indicated a significant negative effect of NS