July 19, 2023

Claims of “natural” or “100% all natural,” which commonly appear on sugary fruit juices in the United States, increase parents’ interest in buying these beverages for their children and make parents think the drinks are healthier, according to a new study led by researchers at the UNC Gillings School of Global Public Health.

“Natural” claims were more likely to lead parents to believe that the beverage was a healthier alternative to other sugary drinks, while both “natural” and “100% all natural” claims made them less likely to understand that the sugary drink contained added sugar.

Words like “natural” and “all natural” are commonly found in marketing for food and beverages in the United States. While research has shown that consumers prefer products that purport to be “natural,” these claims are used broadly and are largely unregulated, which can lead to shopper confusion or the belief that “natural” products are healthful, even when they are not.

Sugar-sweetened beverages are one of the highest sources of excess sugar in American diets, including in children, and contribute to rates of obesity, Type 2 diabetes and other nutritional health problems. Results from this new study suggest that “natural” claims may be misleading to parents and are a large cause for public health and regulatory concern.

Dr. Marissa Hall

Dr. Marissa Hall

“We know that the term “natural” carries no real meaning in terms of the healthfulness of food and drinks, but, understandably, parents – including myself – are drawn to products that are advertised as ‘natural.’ Consumers should be skeptical when they see by this term on foods and drinks,” said Marissa Hall, PhD, the study’s corresponding author, who is an assistant professor of health behavior at the Gillings School and fellow at the UNC Lineberger Comprehensive Cancer Center and Carolina Population Center (CPC)

Hall co-authored the study, published today in the American Journal of Preventative Medicine, along with doctoral students Ana Paula Richter, MPH, Phoebe Ruggles, MS, Isabella Higgins, MPP, and Emily Duffy, MPH, RD, from the Gillings School; Cristina Ji Yeun Lee, MPH, and Anna Grummon, PhD, from the Stanford University School of Medicine; Allison Lazard, PhD, associate professor at the UNC Hussman School of Journalism and Media; and Lindsey Smith Taillie, PhD, associate professor of nutrition at the Gillings School and CPC.

The research team surveyed more than 1,000 U.S. parents or guardians of children between the ages of 2 and 12, randomizing them into groups that viewed an image of a pineapple orange fruit drink with added sugar labeled either with no claim, a “natural” claim or a “100% all natural” claim. The can images used a less popular “Aloha Maid” brand to reduce common brand preferences that parents might have.

The survey asked parents questions about their intent to purchase the juice they viewed for their child(ren), its perceived healthfulness, beliefs about the added sugar and fruit juice content, and the claim’s perceived misleadingness.

Parents who viewed the “natural” or “100% all-natural” claim on a fruit drink expressed greater intentions to buy the fruit drink for their children than those who viewed the drink with no claim. Those who viewed the “natural” claim were more likely to perceive the drink as healthier for their children.

Both claims were more likely to lead parents to the incorrect belief that the fruit drink did not have added sugar and to provide lower estimates of added sugar in the drink.

Parents who viewed either the “natural” or “100% all-natural” claim were also more likely to report that the product packaging was misleading than parents who viewed the drink with no claim.

Importantly, these results did not differ based on the parent’s educational status or the language of the survey. Because participants all saw cans that were identical apart from the claim, researchers say the results add to a growing body of evidence demonstrating strong links between confusing “natural” claims and misperceptions about nutritional content in beverages.

Dr. Lindsey Smith Taillie

Dr. Lindsey Smith Taillie

“Our findings suggest that ‘natural’ claims are deceptive to parents who often have their children’s health at top of mind when shopping for them,” said Taillie. “Stronger regulation of these claims is clearly needed. The Food and Drug Administration (FDA) could create a formal definition of the term ‘natural’ or prohibit these claims on drinks with added sugar. In any case, the onus shouldn’t fall on parents to be on the lookout for misleading marketing claims.”

Taillie and Hall are continuing their work in this space through testing other policy options, like front-of-package warning labels, that could help parents cut through the noise of marketing schemes like “natural” and help them more easily understand which products in the store are truly healthy vs. unhealthy. This research could inform FDA regulation, as the agency is in the process of developing new mandatory front-of-package labels on packaged foods.

Read the full study online.

Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.

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