Objective   To explore the association between the ability to choose prepackaged foods with low salt/sugar/fat and the preference for front-of-pack labeling (FOP) among residents in six provincial-level administrative divisions (PLADs) across China and to provide evidences for the development of domestic FOP.

  Methods   With multistage sampling and a self-designed questionnaire, 3 037 residents aged 18 – 70 years were recruited in six PLADs for a cross-sectional survey from July 2020 to March 2021. Univariate analysis and multivariate logistic regression analysis were conducted with SAS 9.4.

  Results  Complete information were collected from 3 002 of the participants. Of the valid respondents, 54.6% (1 639), 55.3% (1 661), and 54.1% (1 624) reported being able to choose prepackaged foods with low salt, sugar, and fat and 35.4% (1 064) of the respondents considered that the FOP in the format of multiple traffic light (MTL) could help them select healthier food quickly. After adjusting for demographic confounders, the results of logistic regression analysis revealed that in comparison to the respondents with self-reported ability to choose prepackaged food with low salt/sugar/fat, the respondents having a little self-reported ability were more likely to believe the FOP in formats of health logos-smart choice, and nutri-score could help them select healthier food more quickly than the FOP in the format of guideline daily amount (GDA); the respondents having a little ability to choose prepackaged food with low salt or sugar were more likely to believe the FOP in the format of MTL could be more helpful in selecting healthy food than GDA of FOP and the respondents having a little ability to choose prepackaged food with low salt were more likely to believe the FOP in the format of warning labels could be more helpful; while, the respondents without the ability to choose prepackaged foods with low salt/sugar/fat were more likely to believe the FOP in format of smart choice could be more helpful. All the above results are of significance, with the odds ratios of greater than one (P < 0.05 for all).

  Conclusion   In China, nearly a half of residents had a low ability to choose prepackaged foods with low salt/sugar/fat; the FOP format integrating summary indicators on the basis of MTL may hopefully play a role in improving the residents′ ability to choose healthier foods.