Nutrition Facts Label Use and Adherence to the DASH Dietary Pattern: Results From a National Health and Nutrition Survey

Introduction: Whether using nutrition facts labels (NFLs) leads to adherence to higher-quality dietary patterns - such as the Dietary Approaches to Stop Hypertension (DASH) diet, which is associated with lower risk of chronic diseases - is unclear. We investigated whether people aged 21 to 64 years who use NFLs were more likely to adhere to the DASH dietary pattern. Methods: We analyzed data from the nationally representative, cross-sectional Israeli National Health and Nutrition Survey for Adults from 2014-2016. Adherence to the DASH diet was determined from a single 24-hour dietary recall using a DASH score calculated on the basis of adherence to 9 nutrient targets. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% CIs for DASH accordance (DASH score ≥4.5 [accordant] vs DASH score <4.5 [nonaccordant]) and for each separate nutrient target of the DASH diet. Results: The data set comprised 2,579 participants (NFL users, n = 931 [36.1%]). Of the NFL users, 299 (32.1%) were classified as DASH accordant, compared with 339 (20.6%) of the non-NFL users. After adjusting for potential confounders, the OR for DASH adherence among NFL users was 1.52 (95% CI, 1.20-1.93) compared with non-NFL users. Compared with non-NFL users, NFL users' odds of meeting individual DASH nutrient targets were 1.30 (95% CI, 1.06-1.59) for protein; 1.46 (95% CI, 1.17-1.81) for dietary fiber; 1.48 (95% CI, 1.18-1.85) for magnesium; 1.38 (95% CI, 1.12-1.70) for calcium; and 1.60 (95% CI, 1.30-1.97) for potassium. Age, female sex, and performing recommended physical activity were associated with DASH adherence. Conclusion: These results highlight the importance of nutrition education and awareness, as well as the potential role of NFLs in promoting healthier dietary habits.