Chilean food supply sees substantial decreases in sugar, sodium, and saturated fat after front-of-package warning labels required on “high in” foods and drinks

A new study published this week in BMC Medicine examining changes in Chile’s packaged food supply under the country’s mandatory front-of-package warning label law finds sweeping product reformulation to contain less sugar, sodium, saturated fat, and calories. The amount of foods and drinks in Chilean stores that would need “high in” nutrient warning labels dropped from 71% before the law in 2015–2016 to 53% after the law’s third and most strict phase went into effect in 2020.

While the proportion of “high in” products and content of concerning nutrients decreased across all food and beverage categories, researchers saw the greatest reductions in sodium in savory foods and sugars in sweet foods and beverages. Changes in products’ saturated fat content were smaller; however, researchers did find a 20+ percentage point decrease in the proportion of nuts, snacks, and savory spreads requiring warning labels for high saturated fat content. They also found a greater than 20 percentage point drop in savory baked products, breakfast cereals, and savory spreads requiring “high in calories” warning labels.

“We know that before this law, there were almost no significant nutritional improvements in the packaged food supply,” said the study’s first author Natalia Rebolledo, PhD, assistant professor of nutrition at the University of Chile’s Institute of Nutrition and Food Technology. “We also know that voluntary labeling policies have produced minimal changes in product formulation. This study underscores how much more effective a mandatory warning label regulation can be.”

This study highlights one of several ways that front-of-package warning labels work to improve population nutrition: by encouraging the food industry to offer healthier products. Companies wishing to avoid adding warning labels to their packages have an incentive to reduce sugar, sodium, saturated fat, and calorie density in their products. Indeed, this study found that product changes increased as the regulation’s nutritional thresholds tightened with each phase.

Additionally, warning labels nudge consumers towards healthier options or portion sizes as they’re shopping or making food choices at home, and in Chile, the labels are also linked to companion policies that restrict marketing to children and ban sales or promotion in schools for any product with a warning label.

To track changes in the food supply, researchers at the University of Chile photographed thousands of packaged food and beverage products from supermarkets in Santiago, Chile every year from 2015 and 2020. They worked with researchers at the University of North Carolina at Chapel Hill to record nutrition facts panel information for these products, then analyzed how their nutritional profiles changed as the three increasingly strict phases of the Chilean labeling law came into effect.

This study is the latest in a series of policy evaluations showing improvements in the nutritional quality of Chilean’s food purchases, changes in social norms and knowledge around foods and drinks with warning labels, and significant drops in children’s exposure to harmful food marketing. Chile now serves as a model for countries aiming to combat high and rising rates of obesity and other nutrition-related diseases by improving the food environment.

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This research was supported by Bloomberg Philanthropies at part of the Food Policy Program, with additional support from INTA-UNC, INFORMAS, the International Development Research Centre (IDRC), and the ANID/Fondo Nacional de Desarrollo Científico y Tecnológico-FONDECYT Postdoctorado.

STUDY 1 AUTHORS

Natalia Rebolledo
Pedro Ferrer-Rosende
Marcela Reyes
Lindsey Smith Taillie
Camila Corvalán

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Read more in BMC Medicine

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MORE RESEARCH FROM CHILE:

Chileans bought less sugar, salt, saturated fat, and calories at the grocery store after trailblazing warning label law, with high compliance from the food industry Read more…

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Products changed, but not prices, under Chile’s Law of Food Labeling and Advertising Read more…

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Children in Chile saw 73% fewer TV ads for unhealthy foods and drinks following trailblazing marketing restrictions Read more…

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After Chile’s labeling and marketing law, drink purchases contained less sugar and more non-nutritive sweeteners, but overall sweetness stayed the same Read more…

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Study finds no negative economic impact from Chilean food labeling and advertising law Read more…

Two new studies from researchers at the University of Chile and the University of North Carolina at Chapel Hill have added to the evidence that Chile’s front-of-package nutrient warning labels are an effective way to nudge shoppers towards healthier food choices.

The first, published in PLOS Medicine, evaluated Chileans’ grocery purchases during Phase 2 of Chile’s warning label law and found that households bought 37% less sugar, 22% less sodium, 16% less saturated fat and 23% fewer total calories from products with warning labels.

The second study, published in the American Journal of Public Health, found that food and beverage companies in Chile have largely complied with the country’s front-of-package warning label law: In the final and most nutritionally strict phase of the law, researchers found that 94% of products required to carry front-of-package warning labels to indicate high content of sugar, saturated fat, sodium, or calories actually had the appropriate labels on their packages in stores.

Purchase changes

To estimate how Chileans’ shopping choices changed after Phase 2 of the law, researchers at the University of Chile and UNC-Chapel Hill compared data on actual purchases — gathered from 2,844 households in Chile from 2013 to 2019 — to hypothetical food purchases had the law not gone into effect (modeled based on pre-policy trends). Each product in the dataset was profiled by trained nutritionists for nutritional content and ingredients, then categorized as either having or not having a warning label requirement under Chile’s law. They then calculated the differences between the nutritional profile of what purchases were actually made vs. the profile of the expected purchases without a labeling law.

While decreases in purchases of targeted nutrients were partially offset by increases in purchases from products without warning labels, the total change seen across all purchases with and without warning labels was still a significant improvement from pre-policy. Compared to expected purchases had the law not been implemented, Chileans bought 20% less sugar, 14% less sodium, 10% less saturated fat and 8% fewer total calories overall.

For calories and sugar, decreases were the greatest among beverage purchases, including 54% fewer calories bought from warning-labeled drinks. Food purchases, on the other hand, had greater decreases in sodium and saturated fat.

“Our findings confirm what we saw in the earliest phase of the law — that people bought less of the concerning nutrients targeted by warning labels — but we can also see now that these changes were even more pronounced in Phase 2,” said Lindsey Smith Taillie, PhD, associate professor of nutrition at UNC-Chapel Hill and the study’s first author. “This tells us that the healthy shifts Chileans made in their shopping habits were maintained or even improved more over time.”

Researchers also found that decreases in purchases of targeted nutrients were very similar across different socioeconomic groups, suggesting that Chile’s policy did not disproportionately advantage or disadvantage any one group.

Food industry compliance

To measure whether food and beverage companies in Chile were complying with warning label law, researchers at the University Of Chile’s Institute of Nutrition and Food Technology reviewed a set of nearly 10,000 products available in supermarkets in Chile during 2020. They identified which products should have a warning label based on their nutritional content (i.e., if they contained added sugars, sodium, or saturated fat and exceeded set nutrient or calorie limits), then observed whether each package requiring warning labels actually displayed them.

Researchers found that 63% of Chile’s packaged food supply had warning labels, with the two most common labels being “high in energy” (found on 39% of products) and “high in sugars” (on 35% of products). A similar portion of products had one warning label (23%), two labels (20%), or three labels (20%), but only 0.5% of products featured all four warning labels.

They also found that compliance was high — 93% for products requiring warning labels for being high in saturated fat, sodium, or energy and 96% for products requiring a high in sugar warning. Two specific food groups stood out for having lower compliance with the labeling law: non-sausage meat products (e.g., hamburgers) with 84% compliance and soups with 85% compliance.

High industry compliance with this mandatory front-of-package labeling law compared to low uptake of voluntary labeling programs such as Health Star Rating labels (found on only 36% of products in Australia and 30% of products in New Zealand) highlights the strength of mandatory labelling policies.

“Our study’s findings show that food industry is able to make changes to their front-of-package labels when this is mandated by the government and there are clear implementation and monitoring guidelines,” said the study’s first author Natalia Rebolledo, PhD, assistant professor of nutrition at the University of Chile’s Institute of Nutrition and Food Technology. “Continuous monitoring is essential for the success of these policies.”

Proliferation of policies

Chile’s trailblazing 2016 food policy package requiring black “stop sign” warning labels on foods and beverages high in nutrients of health concern ignited rapid adoption of eight similar policies throughout the Americas, with more labels currently under development around the world. The country’s innovative law also featured the world’s most comprehensive national restrictions on food marketing to children and banned the sale or promotion of products with warning labels in schools. Other countries have followed suit by incorporating some of these policy elements into their own laws. For example, Mexico followed Chile’s lead when it implemented similar front-of-package nutrient warnings in 2019 and forbid the use of child-appealing characters on packages with warning labels.

These studies are the latest in a series of evaluations that show how the country’s policy package led to improvements in the nutritional quality of Chile’s food supply, changes in social norms and knowledge around foods and drinks with warning labels, and significant drops in children’s exposure to harmful food marketing — all achieved without negative impacts on product prices or employment and wages. Chile’s approach now serves as a model for other countries aiming to improve the food environment to support better population nutrition and health.

Policymakers, health advocates, and researchers in Chile also continue to build on their successes with new interventions to improve public health. In July 2024, the country began requiring warning labels on alcoholic beverages that disclose calorie counts and warn consumers not to drink while driving, if pregnant, or if under 18 years of age. This law will be complemented by advertising restrictions beginning in 2026. In the past year, researchers also piloted a program that will provide low-income Chileans with funds to purchase fresh fruits and vegetables from local neighborhood markets, both supporting the local economy and increasing access to healthier food options.

“We believe that Chile needs to continue leading the efforts for promoting healthier diets,” said Camila Corvalán, MD, PhD, professor of public nutrition at the University of Chile’s Institute of Nutrition and Food Technology and principal investigator of both studies. “This requires advancing the implementation of other food environment policies that discourage the consumption of ultra-processed foods but also support families — especially those with higher vulnerability — in accessing natural foods for example through fruits and vegetable subsidies.”

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This research was supported by Bloomberg Philanthropies at part of the Food Policy Program, with additional support from INTA-UNC, INFORMAS, the International Development Research Centre (IDRC), and the National Commission for Scientific and Technological Research (Fondecyt Regular and Fondecyt Postdoctorado).

STUDY 1 AUTHORS

Lindsey Smith Taillie
Maxime Bercholz
Barry Popkin
Natalia Rebolledo
Marcela Reyes
Camila Corvalán

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Read more in PLOS Medicine

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STUDY 2 AUTHORS

Natalia Rebolledo
Pedro Ferrer-Rosende
Marcela Reyes
Lindsey Smith Taillie
Camila Corvalán

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Read more in the American Journal of Public Health

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MORE RESEARCH FROM CHILE:

Products changed, but not prices, under Chile’s Law of Food Labeling and Advertising Read more…

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Children in Chile saw 73% fewer TV ads for unhealthy foods and drinks following trailblazing marketing restrictions Read more…

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After Chile’s labeling and marketing law, drink purchases contained less sugar and more non-nutritive sweeteners, but overall sweetness stayed the same Read more…

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Study finds no negative economic impact from Chilean food labeling and advertising law Read more…

Researchers at UNC-Chapel Hill have found that combining taxes on sugary drinks with added messaging on price tags further discourages parents from wanting to buy sugary drinks for their children. 

Currently, over 60 countries and smaller jurisdictions around the world have levied taxes on sugary drinks in an effort to curb their consumption, yet these beverages typically appear with a standard price tag displaying a tax-inclusive price and no additional messages or label requirements.

Researchers wondered how communicating either the price increase from the tax or the high sugar content on price tags might further empower healthy decision-making. 

The study found that all types of enhanced price tags discouraged parents from wanting to buy sugary drinks for their children compared to the standard price tags. Messages about taxes on price tags could reduce purchases of unhealthy products, enabling more health benefits. 

“Even though this policy hasn’t been implemented yet, public health lawyers think it should be legally feasible for policymakers to enact price tag requirements in conjunction with an excise tax on sugary drinks,” said Marissa Hall, PhD, assistant professor in Gillings School of Global Health’s Department of Health Behavior, Global Food Research Program faculty member, and study’s first author.

Read more about this research by Rachel Morrow at the Gillings School of Global Public Health news page.

Read the full article in the American Journal of Preventive Medicine online.

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AUTHORS

Marissa Hall
Phoebe Ruggles
Katherine McNeel
Carmen Prestemon
Cristina Lee
Caitlin Lowery
Aline D’Angelo Campos
Lindsey Smith Taillie

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Learn more about sugary drink taxes around the world.

Findings from a new study in PLOS Medicine conducted by researchers from UNC-Chapel Hill, Stanford University, and the University of Edinburgh indicate that warning label and tax policies effectively reduce purchases of red meat-containing items, such as burger patties, pepperoni pizza, and ham luncheon meat.

Consumption of red meat has gained attention as a nutrition and environmental concern, given its link to harmful climate and health impacts, including high greenhouse gas emissions and increased risk of noncommunicable diseases. The landmark 2019 EAT-Lancet Commission encourages consumers to decrease red meat consumption to improve health and consume a more environmentally friendly diet. Yet, there is limited research assessing how food policies could encourage this decrease in red meat consumption. Warning labels and taxes on processed foods and sugar-sweetened beverages have been found to effectively reduce their purchase and consumption, but this study is the first to assess the impact of warning labels and tax policies specifically on red meat-containing products.

Online shopping for red meat

Researchers randomly assigned participants to a control group or to one of three intervention groups: warning labels, tax, or combined (warning labels + tax). A total of 3,518 participants completed an online shopping task where they were instructed to purchase items from a predetermined 9-item shopping list with a $40 budget: 1 pizza, 1 burrito, burger patties (meat or vegetarian), breakfast sausages (meat or vegetarian), 1 frozen individual meal, 1 loaf of bread, 1 sandwich filling (for example, ham, turkey, or peanut butter), 1 pack of tortillas, and 1 taco filling (for example, steak, chicken, or beans). Researchers counted the number of products that contained red meat and proportion of red meat products in the shopping haul.

They found that warning label, tax, and a combination of both interventions all led to reductions in purchases of red meat-containing items: 39% of control group participants purchased red meat items compared to 36% of those who saw warning labels, 34% of those in the tax group, and 31% of those exposed to a combination of the two interventions.

Exposure to the combined intervention of warnings and the tax also resulted in less calories (-312 kcal) and saturated fat (-12.8 g) in participants’ shopping baskets, but not sodium, when compared to the control group.

“These results show that taxes and warning labels on red meat work similarly to sugary drinks and tobacco, helping consumers reduce their purchases of these products,” said first author Lindsey Smith Taillie, PhD, associate professor and associate chair of academics in the Department of Nutrition at UNC-Chapel Hill’s Gillings Global School of Public Health. “Policies like taxes and warning labels to reduce red meat purchases could yield both public health and environmental benefits.”

Key findings:

“Moving forward, it is also important to determine how to encourage a shift away from red meat purchases to more healthy and environmentally friendly products,” said Taillie. “While reducing red meat is important, we also need to understand the environmental and health impacts of the substitutes that consumers are choosing to ensure the shift does indeed lead to improved outcomes.”

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This research was funded by Wellcome Trust and support from the National Heart, Lung, and Blood Institute of the NIH and the NICHD-NRSA Population Research Training grant.

AUTHORS

Lindsey Smith Taillie
Maxime Bercholz
Carmen E. Prestemon
Isabella C. A. Higgins
Anna H. Grummon
Marissa G. Hall
Lindsay M. Jaacks

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MORE RESEARCH ON RED AND PROCESSED MEATS:

Americans consume red meat from a variety of foods, creating opportunities to introduce meat-free substitutions Read more…

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Health, environmental messages boost Meatless Monday campaign Read more…

The majority of breakfast cereals in South Africa feature child-directed marketing strategies on their packaging, according to a new study in Public Health Nutrition. In an analysis of over 200 breakfast cereals, researchers also found that breakfast cereals with child-directed marketing contained significantly more total sugar and less fiber than cereals without child-directed marketing.

South Africa faces high levels of obesity and other diet-related such as type 2 diabetes, hypertension, cardiovascular disease, and cancer. In April 2023, the National Department of Health released draft regulation R3337, which includes mandatory front-of-package warning labels and restrictions on marketing for products high in nutrients of concern that can cause or worsen NCDs when consumed in excess. Under this regulation, products with warning labels will be banned from making health or nutrition claims, featuring characters on packaging, and using other direct and indirect marketing strategies to appeal to children and their parents.

Research shows that marketing is a key factor in promoting consumption of ultra-processed products high in salt, sugar, saturated and trans fats, and calorie density. Children and adolescents are developmentally vulnerable to advertising and other marketing tactics and are highly targeted, often for food and beverage companies’ least-healthy products. Food and beverage advertising has remained unregulated even though children’s rights are guaranteed in the South African Constitution.

In this study, researchers assessed the nutritional composition of 222 breakfast cereals as well as the presence of direct child marketing strategies on packaging (e.g., illustrations, characters, fantasy, role models), and indirect marketing to children’s parents (nutritional claims and health claims). Breakfast cereals with direct child marketing strategies had lower levels of protein and fiber and higher total sugar and carbohydrate content than those without direct marketing strategies. 

Key findings:

This research was funded by Bloomberg Philanthropies.

AUTHORS

Alice S. Khan
Tamryn Frank
Rina Swart

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MORE RESEARCH FROM SOUTH AFRICA:

Nutrient warning labels work in South Africa: Results from a randomized controlled trial Read more…

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Beverage industry ad spend and airtimes in South Africa Read more…

Despite extensive product reformulation after Chile began requiring warning labels on the front of less-healthy food and drink packages, Chilean consumers saw no significant change in food and beverage prices associated with the policy in the first year and a half. This was the main finding of a new study from researchers at Universidad Adolfo Ibáñez, Universidad de Chile, and the University of North Carolina at Chapel Hill that examined price changes after the Law of Food Labeling and Advertising took effect in 2016.

After Chile began mandating warning labels on products high in calorie density or added sugars, salt, or saturated fat, some food and beverage manufacturers changed the nutritional composition of their products to avoid the label requirement. These reformulations could have led to changes in product prices in two ways, according to first author Guillermo Paraje, professor of economics at the Universidad Adolfo Ibáñez in Chile: “Reformulation could have increased firms’ costs, leading to higher prices if companies passed on the cost to consumers. Additionally, consumers may have been attracted to reformulated products without warning labels, increasing their demand and hence, their prices.”

Researchers compared prices of products with and without warning labels to a control group of products that remained unregulated (did not require warning labels) throughout the study period. They used pricing information from a large database containing prices for packaged food purchases from over 2,500 households from January 2014 to December 2017 (before and after the labeling law took effect). A team of trained nutritionists reviewed and categories all the purchased products by regulation status, i.e., whether they would be required to carry one or more warning labels. Researchers then analyzed changes before and after the law began in both levels and trends of absolute prices using the Laspeyres Price Index.

They found no significant change in prices of labeled products relative to unlabeled products. Rather, prices for both product groups continued to follow their pre-regulatory trends or changed in similar ways following the law. Researchers also compared these price changes within different “shopping baskets” or preferred foods and drinks for different socio-economic groups, and similarly found no significant differences in price changes.

“A common argument we hear from industry is that regulations like this are too costly and hurt consumers and the economy,” said senior author Barry Popkin, W. R. Kenan Jr. Distinguished Professor of Nutrition at UNC-Chapel Hill. “We see here that Chile’s law did not lead to more expensive prices on healthier options, and we’ve seen in previous studies that there was no impact on employment or wages.”

This study adds to a growing body of evidence on the impacts of Chile’s Law of Food Labeling and Advertising, which in addition to requiring front-of-package warning labels also restricts marketing for unhealthy foods and bans their sale or promotion in schools. For example, previous research has found that the policy package was associated with decreased calories, sugar, sodium and saturated fat purchased from regulated foods and drinks as well as significant drops in children’s exposure to TV advertising for regulated products. More long-term evaluations of the fully implemented regulation are expected in the coming year.

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This research was funded by Bloomberg Philanthropies.

AUTHORS

Guillermo R Paraje
Universidad Adolfo Ibáñez

Daniela Victoria Lucía Montes de Oca Carreño
Universidad de Chile

Camila Corvalán
Universidad de Chile

Barry M Popkin
UNC-Chapel Hill

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EVALUATIONS OF PRODUCT REFORMULATION IN CHILE

Changes in the amount of nutrient of packaged foods and beverages after the initial implementation of the Chilean Law of Food Labelling and Advertising: A nonexperimental prospective study Read more…

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Changes in the use of non-nutritive sweeteners in the Chilean food and beverage supply after implementation of the Food Labeling and Advertising Law Read more…

Two recent studies conducted by researchers from the Global Food Research Program at UNC-Chapel Hill and the University of Chile have found that in the first phase of Chile’s Law of Food Labeling and Advertising, consumers’ beverage purchases contained less sugar and more non-nutritive sweeteners (e.g., Aspartame, Stevia, or Sucralose), but overall beverage sweetness stayed the same.

The requirement under Chile’s law for products high in calories or added sugar, salt, saturated fat to carry a front-of-package warning label has prompted the food and beverage industry to reformulate and introduce new products in order to avoid regulation. For example, companies have reduced the amount of added sugars in drinks to fall below the law’s sugar threshold, while replacing some of that sugar with non-nutritive sweeteners to maintain a similar taste. One study found that the share of beverages in Chile containing non-nutritive sweeteners increased by more than 10% after the law came into effect.

Taste test: beverage sweetness

In a study published in Frontiers in Nutrition in October 2022, researchers found that Chile’s policies were not associated with changes in overall sweetness taste of the beverages consumers bought, despite evidence of product reformulation to contain less sugars and more non-nutritive sweeteners (which can taste 10–20,000 times sweeter than sugars).

“We wanted to look at overall change in sweetness to understand what consumers were being exposed to, as a result of reformulation,” said Natalia Rebolledo, postdoctoral researcher at the Center for Research in Food Environments and Prevention of Nutrition-Related Chronic Diseases (CIAPEC) at the University of Chile and the study’s first author. “We focused on beverages because they are the main dietary source of added sugars and non-nutritive sweeteners in the Chilean diet.”

For this study, researchers analyzed the weekly grocery purchases of over 2,000 households before and after the labeling law began and evaluated the total sweetness of purchases. They did this by creating a “sweetness index” to measure and compare levels of non-nutritive sweeteners, total sugars, and total combined sweetness in each beverage purchased, taking into account the unique levels of sweetness tastes from non-nutritive sweeteners and sugars. The team used data from the Chilean Nutritional Facts Panel, which provided the actual amounts of total sugars and non-nutritive sweeteners included in the drinks purchased by study households.

Key findings during Phase 1 of the law:

This is the first study to analyze whether beverage sweetness changed based on the type of sweetener used (sugars and/or non-nutritive sweeteners) after the implementation of the Law of Food Labeling and Advertising in Chile.

Sweetener purchases

The team’s next study, published in Current Developments in Nutrition in December 2022, examined changes in purchases of foods and beverages sweetened with non-nutritive and caloric sweeteners after Phase 1 of the law.

Using the same dataset of weekly grocery purchases from over 2,000 households, researchers analyzed the sweetener content of purchased foods and beverages before and after the labeling and marketing law began. They created four product categories based on the types and combination of sweeteners used in each product purchased:

1. No added sweeteners used;
2. Caloric sweeteners used, but no non-nutritive sweeteners used;
3. Non-nutritive sweeteners used, but no caloric sweeteners used; and
4. Both caloric and non-nutritive sweeteners used.

Researchers then analyzed products purchased products in each category before and after the law.

Key findings during Phase 1 of the law:

This is the first study to analyze the change in purchases of sweeteners in food and beverages after the implementation of the Law of Food Labeling and Advertising in Chile.

Both of these studies add to previous research evaluating the impact of Chile’s Law of Food Labeling and Advertising on intake, including a study from the same research team finding that preschoolers increased their non-nutritive sweeteners intake by 14 percentage points in the first year of the law.

Rebolledo says of their findings, “It is positive that beverages did not get sweeter as a result of higher non-nutritive sweetener use. It appears that both the beverage industry and consumers are substituting caloric sweeteners with non-nutritive sweeteners, which could have long-term health impacts that we need to better understand. We need to continue monitoring the following phases of the law to see if Chileans changed their purchasing habits after the requirements for warning labels and marketing became stricter.”

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This research was funded by Bloomberg Philanthropies, National Institutes of Health, National Commission for Scientific and Technological Research (CONICYT), and Becas Chile Doctorado 2017.

AUTHORS

Natalia Rebolledo
Maxime Bercholz
Linda Adair
Camila Corvalán
Shu Wen Ng
Lindsey Smith Taillie

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What are non-nutritive sweeteners?

Non-nutritive sweeteners are sweeteners that have intensely sweet taste and typically do not contribute calories or are very low in calories. Non-nutritive sweeteners can be naturally occurring/derived from plants (e.g., sorbitol, xylitol, erythritol, stevia glycosides, monk fruit extract) or synthetic/”artificial” (e.g., aspartame, saccharin, sucralose, or acesulfame potassium).

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FACT SHEETS

Read more about the evidence for front-of-package labels and marketing restrictions.

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Learn more about Chile’s policies and our evaluation work there.

A new study published this month in the journal Food Policy finds that Peru’s food and beverage industry experienced no significant job or wage losses after the country began taxing sugary drinks and putting warning labels on the front of unhealthy food and beverage packages prior to the COVID-19 pandemic.

The Peruvian government implemented these two policies to help lower the country’s burden of diet-related diseases such as obesity, diabetes, and heart disease. In 2018, Peru increased its sweetened beverage tax for drinks containing six or more grams of sugar per 100 mL, and in 2019, the country began requiring front-of-package warning labels on foods and beverages high in sugar, saturated fats, or sodium or containing trans fats.

In opposition to taxes and front-of-package warning label policies now adopted throughout Latin America and the rest of the world, food and beverage industry representatives have argued that these regulations would cause substantial job loss and economic harm. This study adds to a growing body of evidence that they do not. Previous scientific studies that looked at economic impacts following implementation of sugary drink taxes in Mexico and the United States and front-of-package warning labels in Chile similarly found no negative impacts on employment and wages. This is the first study to examine the combined effect of a tax and a front-of-package labeling policy in one country.

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“Food and beverage industry representatives have argued that these regulations would cause substantial job loss and economic harm. This study adds to a growing body of evidence that they do not.”

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The authors explain that the lack of negative economic impact is likely due to a combination of industry adaptations (reformulating products to avoid regulation and/or reallocating their labor force and resources to focus on unregulated products) and consumer behaviors (e.g., consumers making substitutions to products produced by the same firms).

This research was funded by Bloomberg Philanthropies.

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Other recent research from Peru:

Read the full paper in Food Policy:

AUTHORS

Juan-José Díaz
Alan Sánchez
Francisco Diez-Canseco
J. Jaime Miranda
Barry Popkin

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RESOURCES

Learn more about front-of-package labels around the world and the evidence for these policies.

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Learn more about sugary drink taxes around the world and evidence for these policies.

A new study from South Africa comparing three different front-of-package (FOP) labeling schemes found that a nutrient warning label helped more participants correctly identify unhealthy products and more strongly reduced their intention to purchase those products, compared to a “multiple traffic light” label and a Guideline Daily Amounts label.

These findings, published in Appetite, come at an important time as South African policymakers consider draft regulation for the country’s first mandatory front-of-package label. While research from other countries has found that nutrient warning labels are the stronger FOP label option for identifying and discouraging consumption of unhealthy foods, some studies find that other labels, such as the traffic light, can also be effective. This suggests that context plays an important role and underscores the importance of testing a label designed specifically for South Africa.

“It was important to create a warning label for South Africa that can help people from different language backgrounds and literacy levels make informed decisions on what to buy and eat,” said Makoma Bopape (left), first author and Senior Lecturer in Human Nutrition and Dietetics at the University of Limpopo. “We achieved this using a triangle shape and exclamation mark that are associated with ‘warning’ in South Africa and by including icons for each nutrient, for example a saltshaker for sodium.”

In a randomized controlled trial, researchers from the University Limpopo, the University of the Western Cape, the University of Antwerp, and the University of North Carolina at Chapel Hill compared how well the different label types helped South African consumers:

• Identify products high in sugar, salt, or saturated fat;
• Identify unhealthy products; and
• Reduce intention to purchase unhealthy products.

Participants were randomly selected from the general South African population, which resulted in a representative sample of nearly 2,000 households. They first answered questions about a set of fictional products with no FOP labels, as a control condition. Next, they were randomly assigned to one of the three FOP label conditions and shown another set of products featuring that label. They then answered the same questions about the labeled products.

Researchers measured how many participants in each group correctly identified products high in nutrients of concern (sugar, salt, and saturated fat), how many correctly identified products as unhealthy, and whether participants’ intention to purchase the unhealthy products changed after seeing them with a specific FOP label.

“These findings are consistent with a rapidly growing body of evidence from around the world showing that warning labels are the most effective label type for helping consumers rapidly identify unhealthy foods — and perhaps more importantly, discouraging consumers from buying them,” said Lindsey Smith Taillie (right), co-author and Associate Professor of Nutrition at the University of North Carolina at Chapel Hill.

This research comes on the heels of another study by Bopape, Taillie, and Rina Swart, senior author and professor in Dietetics and Nutrition at the University of the Western Cape, in which they examined how the same warning labels impacted parents’ food purchasing decisions and perceptions of unhealthy foods. When shown images of products with warning labels, parents said they would buy less of the foods with warning labels and switch to non-labeled, healthier options. Parents in the study also expressed that their children’s health was their top priority. Warning labels made them think about future health impacts if their children continued eating ultra-processed foods high in sodium, sugar, and saturated fat.

Like many countries worldwide, South Africa faces high rates of obesity and other diet-related diseases including type 2 diabetes, hypertension, and heart disease — all exacerbated by consuming a diet high in sugar, sodium, or saturated fat. In addition to helping consumers easily and more accurately identify foods high in nutrients of concern and discourage purchases of those products, requiring FOP warning labels on the least-healthy foods and drinks could incentivize industry to offer healthier product choices.

Policies using similar FOP nutrient warning labels have already been implemented or passed in ten other countries — most in the last three years. Evidence of their impact in Chile, where FOP warning labels have been required on unhealthy packaged foods and drinks since 2016, suggests that findings from experiments like this one in South Africa can translate into real, population-level changes in shopping behavior once a policy is implemented. In its first year, Chile’s FOP warning label policy was associated with a 24% drop in sugary drink purchases and declines in sodium (–37%), total calories (–24%), calories from sugar (–27%), and calories from saturated fat (–16%) purchased from all foods and beverages.

“If South Africa adopts the labels used in this study into the current draft regulations, ours will be the first African country and second country in the world after Israel to use a mandatory warning label with icons for different nutrients,” said Swart (left). “In addition to helping guide South African consumers toward healthier choices on what to buy, eat, and feed their families, this could provide important evidence for other countries that have diverse languages and literacy levels.”

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This research was funded by Bloomberg Philanthropies.

For inquiries, contact Emily Busey.

Read the full paper in Appetite:

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AUTHORS

Makoma Bopape
University of Limpopo,
University of the Wester Cape

Jeroen De Man
University of Antwerp

Lindsey Smith Taillie
UNC-Chapel Hill

Shu Wen Ng
UNC-Chapel Hill

Nandita Murukutla
Vital Strategies, New York

Rina Swart
University of the Western Cape

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RESOURCES

Read more about the evidence for front-of-package labels.

View different front-of-package labeling policies around the world.