Date of Award

Fall 2022

Document Type

Open Access Dissertation


Health Promotion, Education and Behavior

First Advisor

Rachel E. Davis


Despite the promise of Nutrition Facts label (NFL) use as a population-level intervention with broad reach, few studies have examined determinants of adolescents’ NFL use, and how this label use may be associated with nutrition behaviors. This study used data from the International Food Policy Study, an online cross-sectional survey of trends in dietary patterns and policy-relevant behaviors in the U.S. and five other countries. First, this study examined 1) whether NFL use was associated with healthy eating efforts and 2) whether there were sociodemographic differences in NFL use among U.S. adolescents. Results demonstrated that NFL use was positively associated with a set of healthy eating behaviors among U.S. adolescents. Older adolescents had less frequent use of the NFL than younger adolescents, and this association was mediated by NFL understanding and nutrition knowledge. Next, this study examined potential 1) associations between weight change or maintenance efforts and NFL use and 2) relationships between three factors (body satisfaction, social media use, and weight teasing) predicted to be associated with weight change or maintenance efforts. Adolescents trying to change or maintain their weight were more likely to use the NFL than those not trying to change their weight. Compared to adolescents who were satisfied with their body size, those who perceived their body as smaller than ideal were more likely to try to gain weight, and those who perceived their body as larger than ideal were more likely to be trying to lose weight. Adolescents who had experienced weight teasing were more likely to engage in weight change or maintenance efforts than adolescents who had not been teased for their weight. More time on social media was associated with trying to lose weight. Overall, this research makes significant contributions to public health research and practice. For one, unlike the literature among adults, little research has examined about the effect of adolescents’ use of the NFL on healthy eating behaviors. As NFL understanding and nutrition knowledge may be barriers to NFL use, efforts to increase understanding and knowledge may lead to higher NFL use. Findings also point to the need for targeted efforts to promote body size satisfaction, reduce weight teasing, and encourage social media literacy among adolescents, which may help adolescents achieve and maintain healthy eating practices. The establishment of healthy eating behaviors during adolescence is important because nutrition habits established during this time period are likely to carry into adulthood.


© 2022, Jennifer Beth Mandelbaum