{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:48:43Z","timestamp":1760233723744,"version":"build-2065373602"},"reference-count":68,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Programme for the Promotion of Healthy Eating (PNPAS), General Directorate of Health, Portugal","award":["-"],"award-info":[{"award-number":["-"]}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/04295\/2020 and UIDP\/04295\/2020"],"award-info":[{"award-number":["UIDB\/04295\/2020 and UIDP\/04295\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study aimed to describe the underlying process, used methods and major recommendations emerging from a comprehensive and prospective health impact assessment of the endorsement of a front-of-pack nutrition labelling (FOP-NL) system by the Portuguese health authorities. A mixed-methods approach was used to gather information on the impact of four FOP-NL schemes on consumers\u2019 selection of food products according to the perception of their nutritional quality, combining a systematic literature review, focus groups (FG), in-depth individual interviews, and an open-label crossover randomized controlled study. The relevance of FOP-NL as a public health promotion policy has emerged as a consensual idea among either FGs\u2019 participants (i.e., consumers and experts), or interviewed stakeholders. Although all of the evaluated FOP-NLs result better than no system on promoting the choice of the healthiest product, the effectiveness of easy-to-interpret FOP-NL among vulnerable groups raised concerns related to the need of integrating specific nutritional information to promote a better self-management of chronic diseases, and related to the level of literacy of consumers, which could impair the usage of FOP-NL. Educational campaigns addressing skills to use FOP-NL is recommended. Furthermore, a monitoring strategy should be considered to evaluate the long-term effectiveness of this policy in promoting healthier food choices, and in reducing diet-related non-communicable diseases burden.<\/jats:p>","DOI":"10.3390\/ijerph18041422","type":"journal-article","created":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T20:31:51Z","timestamp":1612384311000},"page":"1422","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Looking Ahead: Health Impact Assessment of Front-of-Pack Nutrition Labelling Schema as a Public Health Measure"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5780-2288","authenticated-orcid":false,"given":"Rodrigo","family":"Feteira-Santos","sequence":"first","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4807-5904","authenticated-orcid":false,"given":"Violeta","family":"Alarc\u00e3o","sequence":"additional","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal"},{"name":"Centro de Investiga\u00e7\u00e3o e Estudos de Sociologia, ISCTE-Instituto Universit\u00e1rio de Lisboa (ISCTE-IUL), Avenida das For\u00e7as Armadas, 1649-026 Lisboa, Portugal"}]},{"given":"Osvaldo","family":"Santos","sequence":"additional","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal"},{"name":"Unbreakable Idea Research, 2550-426 Painho, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0428-6643","authenticated-orcid":false,"given":"Ana","family":"Virgolino","sequence":"additional","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal"}]},{"given":"Jo\u00e3o","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal"}]},{"given":"Carlota Pacheco","family":"Vieira","sequence":"additional","affiliation":[{"name":"Dire\u00e7\u00e3o-Geral da Sa\u00fade, Alameda Dom Afonso Henriques, 1000-123 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0380-7833","authenticated-orcid":false,"given":"Maria","family":"Jo\u00e3o Greg\u00f3rio","sequence":"additional","affiliation":[{"name":"Dire\u00e7\u00e3o-Geral da Sa\u00fade, Alameda Dom Afonso Henriques, 1000-123 Lisboa, Portugal"},{"name":"Programa Nacional para a Promo\u00e7\u00e3o da Alimenta\u00e7\u00e3o Saud\u00e1vel, Dire\u00e7\u00e3o-Geral da Sa\u00fade, Alameda Dom Afonso Henriques, 1000-123 Lisboa, Portugal"},{"name":"Faculdade de Ci\u00eancias da Nutri\u00e7\u00e3o e Alimenta\u00e7\u00e3o da Universidade do Porto, Rua do Campo Alegre 823, 4150-180 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8316-5035","authenticated-orcid":false,"given":"Paulo","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal"},{"name":"Dire\u00e7\u00e3o-Geral da Sa\u00fade, Alameda Dom Afonso Henriques, 1000-123 Lisboa, Portugal"},{"name":"Laborat\u00f3rio de Biomatem\u00e1tica, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2727-4402","authenticated-orcid":false,"given":"Andreia","family":"Costa","sequence":"additional","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal"},{"name":"Dire\u00e7\u00e3o-Geral da Sa\u00fade, Alameda Dom Afonso Henriques, 1000-123 Lisboa, Portugal"},{"name":"Escola Superior de Enfermagem de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal"}]},{"given":"Pedro","family":"Gra\u00e7a","sequence":"additional","affiliation":[{"name":"Dire\u00e7\u00e3o-Geral da Sa\u00fade, Alameda Dom Afonso Henriques, 1000-123 Lisboa, Portugal"},{"name":"Programa Nacional para a Promo\u00e7\u00e3o da Alimenta\u00e7\u00e3o Saud\u00e1vel, Dire\u00e7\u00e3o-Geral da Sa\u00fade, Alameda Dom Afonso Henriques, 1000-123 Lisboa, Portugal"},{"name":"Faculdade de Ci\u00eancias da Nutri\u00e7\u00e3o e Alimenta\u00e7\u00e3o da Universidade do Porto, Rua do Campo Alegre 823, 4150-180 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,3]]},"reference":[{"key":"ref_1","unstructured":"WHO (2018). 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