Association between the diagnosis of diet-related non-communicable diseases and the use of nutritional labeling among Mexican, Mexican American, and non-Mexican American adults: a cross-sectional study from the International Food Policy Study 2021-2022.

Background: Diet-related non-communicable diseases (NCDs) are a leading cause of morbidity and mortality worldwide. Front-of-package warning labels (WLs) and nutrition facts labels (NFLs) have been implemented to help consumers make healthier choices, yet little is known about their use among individuals with NCDs or across different population groups. Understanding these patterns is essential to evaluate labeling policies and their potential to support healthier diets. This study aimed to examine the association between NCD diagnosis and WL use among Mexican adults, and to compare NFL use across Mexican, Mexican American, and non-Mexican American adults. Methods: This study used cross-sectional data from the 2021 and 2022 International Food Policy Study. We analyzed self-reported WL and NFL use and NCD diagnoses (diabetes, hypertension, heart disease, high cholesterol, cancer) among adults in Mexico, Mexican Americans, and non-Mexican Americans. Multivariate logistic regression models assessed associations between label use and NCD status, adjusting for sociodemographic and health-related confounders. Results: Among 23,951 adults, NFL use was highest among non-Mexican Americans (80.1%) and lowest among Mexicans (69.8%, p < 0.01). NFL use was significantly associated with diabetes and multiple NCDs in non-Mexican Americans. In Mexico, WL use (77.4%) exceeded NFL use. Mexicans with diabetes and high cholesterol reported that "Excess Sugar" and "Excess Sodium" labels were particularly helpful. Conclusions: Labeling use varied across populations and NCD status. Findings highlight the importance of promoting interpretive front-of-package labels, especially among individuals with NCDs, to encourage healthier food choices and reduce diet-related disease burden.