Setting type, spacing and emphasis for comfortable reading
Typography makes text physically readable and shows how its parts relate. Type size and family, line length, spacing, alignment and restrained emphasis help readers find and follow the information they need.
Type size and family
A 2007 print-typography recommendation gives two starting points:
- Size: aim for twelve-point type; if space is tight, eleven or ten points may be used, but not smaller. For readers likely to have visual difficulties, it cites the Royal National Institute for the Blind's minimum of fourteen points.
- Shape: sans-serif faces such as Arial are generally considered easier to read than serif faces such as Times New Roman.
Patient-information design guidance favours type as large as possible.
A 2012 recommendation uses Times New Roman or Arial twelve-point for most body text and Arial ten-point for tables where space is tighter. It distinguishes screen and paper: Word 2010's Calibri eleven-point default can look pleasant on screen yet small when printed.
Small type can be difficult even when there is room for more: a 2013 Mepilex Lite dressing leaflet used approximately 5.5-point text in a sixty-four-page multilingual booklet with twenty-four blank pages. For an older readership, a pain-management book combined large type, extra leading and clear photographic illustrations to accommodate age-related visual problems.
Line length, leading and alignment
Line length varies with the document, including web pages and newspaper-style columns. Leading is the space between lines; it should exceed word spacing, with twelve-point leading a normal setting for ten-point body text.
Left alignment with a ragged right margin is recommended for most documents because full justification varies word spacing to make lines equal in length. A fully justified block can also look monotonous and tire readers; ragged-right text combined with white space and headings can be easier to read.
White space and paragraph boundaries
White space can keep text from looking overwhelming, separate ideas into manageable pieces and highlight important information. Extra space between definitions and descriptions can give each a distinct identity instead of letting crucial ideas run together in dense paragraphs.
Four spacing recommendations are:
- Margins: use one inch or 2.5 centimetres on all sides; smaller margins crowd text, while larger ones can distract.
- Paragraphs: add space before and after paragraphs or at least indent the first line to separate ideas.
- Headings: leave space before and after them so they are easy to see.
- Lines: double-space drafts to allow handwritten editorial marks and comments; double spacing is commonly required for journal submissions.
For patient documents, one recommendation is approximately equal areas of print and blank space, at least twelve-point mixed-case type, flush-left text with a ragged right margin, sparing boldface and avoidance of underlining.
Patient-page layout
Even skilled readers can tire of unfamiliar health topics, while less-skilled readers may give up after previous frustrating experiences; text therefore needs to look easy as well as be easy to read. A patient-information checklist recommends:
- Keep most sentences and paragraphs short.
- Use several headings to avoid a dense appearance.
- Use a line length of about fifty characters and spaces, within a range of forty to seventy.
- Leave plenty of white space.
- Use twelve-point type or larger.
- Avoid all capital letters.
- Include illustrations, examples and testimonials.
A health-literacy handbook's design advice adds:
- Use at least fourteen-point type for older audiences.
- Take care with capital letters.
- Align text left, since justification can produce odd-sized spaces.
- Use bulleted lists.
- Use contrast through bolder headings, pictures of different sizes and colour highlighting.
Emphasis
Three forms of emphasis should be avoided or limited:
- Block capitals: they are harder to read and can look like shouting.
- Underlining: it can obscure descenders and close letter shapes.
- Italics: too much, especially at small sizes, is difficult to read.
Bold is a useful alternative, but any emphasis loses effect if overused. Underlining may also be mistaken for a hyperlink, and italics can be difficult in print; boldface may therefore be the best choice, used sparingly and mainly for titles and headings. Patient-information design guidance specifically recommends bold lower-case text for emphasis.
Colour
A 2012 technical-document recommendation advises avoiding coloured text in most documents: monochrome printing can make colours appear pale grey, and colour may look out of place. For electronic, web or marketing materials where colour is useful, it recommends no more than three or four colours, chosen to remain visible on screen and paper and distinguishable across monitors, projectors and printers. Red and green should not be paired because many readers cannot distinguish them.
The accompanying text-colour palette is:
| Background | Recommended | Avoid |
|---|---|---|
| White | Black, blue, red | Yellow, cyan |
| Black | White, yellow, green | Blue, red, magenta |
Heading hierarchy
Sections and subsections make long documents manageable and add white space; headings should identify their content, remain short and inviting, and follow a consistent format. For example, headings for demographics, efficacy and safety let a clinical-trial manuscript reader go directly to the required results.
Three levels are usually adequate, distinguished by size and style. A 2012 scheme uses:
| Level | Example formatting |
|---|---|
| Document title, Heading 1 | Arial sixteen-point bold. |
| Section, Heading 2 | Arial fourteen-point plain capitals. |
| Subsection, Heading 3 | Arial twelve-point italics. |
A different body-and-heading scheme uses Times New Roman twelve-point body text with Arial sixteen-point bold, twelve-point bold and twelve-point italic headings; consistency and a limited number of styles matter whichever scheme is selected.
Lists
Lists divide related information into manageable pieces and add white space. Items should have consistent format and structure, begin with capitals and end with full stops when they are sentences; the introduction should end with a noun describing the items followed by a colon.
Three list types serve different purposes:
- Numbered lists: show sequential steps or rankings, with one action per step.
- Bulleted lists: show nonsequential items or choices for scanning; independent entries may obscure how they fit together, so paragraphs can sometimes be more effective.
- Checklists: track completion of required steps.
One recommendation limits lists to roughly nine items, dividing longer ones into shorter groups. Patient-document advice suggests six to eight and labelled groups, such as citrus fruit and melons within a long fruit list. Where paragraph numbering is needed for cross-reference, complicated academic-style forms such as 1.2.1.b should be avoided.