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Simplifying healthful choices: a qualitative study of a physical activity based nutrition label format

Jonas J Swartz1*, Sunaina Dowray2, Danielle Braxton3, Paul Mihas4 and Anthony J Viera5

Author affiliations

1 Department of Obstetrics and Gynecology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., L 466, Portland, OR 97239, USA

2 University of North Carolina School of Medicine, Chapel Hill, NC, USA

3 University of North Carolina Center for Health Promotion and Disease Prevention, Chapel Hill, NC, USA

4 The Odum Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

5 Department of Family Medicine, University of North Carolina School of Medicine, and Public Health Leadership Program, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA

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Citation and License

Nutrition Journal 2013, 12:72  doi:10.1186/1475-2891-12-72

Published: 6 June 2013



This study used focus groups to pilot and evaluate a new nutrition label format and refine the label design. Physical activity equivalent labels present calorie information in terms of the amount of physical activity that would be required to expend the calories in a specified food item.


Three focus groups with a total of twenty participants discussed food choices and nutrition labeling. They provided information on comprehension, usability and acceptability of the label. A systematic coding process was used to apply descriptive codes to the data and to identify emerging themes and attitudes.


Participants in all three groups were able to comprehend the label format. Discussion about label format focused on issues including gender of the depicted figure, physical fitness of the figure, preference for walking or running labels, and preference for information in miles or minutes. Feedback from earlier focus groups was used to refine the labels in an iterative process.


In contrast to calorie labels, participants shown physical activity labels asked and answered, “How does this label apply to me?” This shift toward personalized understanding may indicate that physical activity labels offer an advantage over currently available nutrition labels.

Calorie label; Menu label; Nutrition information; Restaurant label; Patient protection and affordable care act; Obesity; Food away from home; Fast food