Introduction The effects of front-of-package nutrition labels among Latino and Hispanic (“Latine”) adults in the US, including those with limited English proficiency, remains largely unknown. We examined the impact of different types of labels among Latine consumers and whether effects differed by English proficiency.

Study design Online randomized trial.

Setting/participants 3,053 Latine US adults (49% limited English proficiency).

Intervention Participants viewed one of three labels: numerical labels displaying numerical information about sodium, saturated fat, and added sugar; text high-in labels stating when foods are high in these nutrients of concern; and icon high-in labels identical to the text labels plus a magnifying glass icon.

Main outcome measures Participants viewed three frozen pies, three frozen pizzas, and three frozen meals displaying randomly assigned labels and identified the healthiest and least healthy product within each group (based on nutrient content).

Results Text high-in labels (49% correct) led to higher correct identification of the least healthy foods compared to the numerical labels (44%, p<.001) though the icon high-in labels did not (47%, p=.07). Neither the text high-in labels (46% correct) nor the icon high-in labels (46%) led to better identification of the healthiest food compared to the numerical labels (45%, all p>=.71). Neither type of high-in label led to more correct identification of foods high in nutrients of concern or higher selection of the healthiest food for purchase compared to the numerical labels (all p>=.09). English proficiency moderated the impact of label type on correct identification of the least healthy food (p-interaction=.003) such that the benefit of high-in labels was only present for participants with high English proficiency.

Conclusions High-in labels helped Latine consumers identify unhealthy foods more than numerical labels, but only among those with high English proficiency. Future food labeling research should include participants with limited English proficiency.

Trial registration NCT06293963.

The authors have declared no competing interest.

NCT06293963

This research was supported by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation. J.F. was supported by USDA National Institute of Food and Agriculture (NIFA) Hatch project #7005204. A.H.G. was supported by K01 HL158608 from the National Institutes of Health. The other authors did not have any funding sources. The funders did not play a role in the study design; collection, analysis, and interpretation of data; writing the report; or the decision to submit the paper.

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IRB of University of North Carolina at Chapel Hill gave ethical approval for this work.

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