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…

A new global review of school food policies published in Advances in Nutrition found that only 16% of countries worldwide have national policies restricting food marketing in schools, and only 25% have national policies restricting in-school sales of foods high in nutrients or ingredients of concern outside school meal programs. A mere 12% of countries have national policies restricting both.

Children around the world spend much of their days in schools, and many eat at least one meal a day there. This makes the school food environment a critical influence not only on what kids eat, but also potentially on their lifelong food preferences and dietary habits. To protect and enhance this environment, the World Health Organization and other public health leaders encourage policies to restrict children’s access and exposure to unhealthy foods and beverages in and around schools.

This scoping review study sought to assess the global landscape of national-level, mandatory policies related to food marketing and competitive food sales in in schools. To that end, researchers systematically searched all 193 United Nations countries for the presence of these national regulations:

• Restricting sales of competitive foods: “Competitive foods” are any foods or beverages sold in schools outside of a national school meal program. This includes foods sold in canteens, kiosks, tuck shops, vending machines, and from vendors coming onto school grounds.
• Restricting food marketing: Any oral, written, or graphic statements made to promote the sale of a food or beverage product. In schools, this can include featuring brand logos, spokes-characters, or product images on signs, scoreboards, vending machines, or other school equipment; branded sponsorship of incentive programs or school discount nights (e.g., at fast food restaurants), ads in school newspapers or yearbooks; fundraiser incentives; scholarships; and more.

“Decades of research clearly show that exposure to marketing for unhealthy foods and drinks harms children and adolescents and increases their risk for childhood obesity,” said first author Michelle Perry, MS, former Global Food Research Program research specialist and current doctoral student at Brown University School of Public Health. “This should be limited everywhere, but marketing especially has no place in schools. We expect the learning environment to foster knowledge and health, not entice food brand loyalty and eating behavior at odds with dietary guidelines.”

Researchers used a combination of global policy databases, peer-reviewed literature, official government websites, internet searches, and in-country experts to identify policies. For each policy, they gathered information on key features including how foods are nutritionally profiled, whether monitoring and enforcement language are included, and whether policies apply to the area around schools. They also examined trends in policy adoption by country income groups and found that over half of policies were found in high-income countries, and no low-income countries had either policy type.

“We may not have found these policies in low-income countries because of differences in food provision priorities, resources, or availability in schools,” said Barry Popkin, PhD, W.R. Kenan Jr. Distinguished Professor of Nutrition at the UNC Gillings Global School of Public Health, co-director of the Global Food Research Program, and the study’s senior author. “In these countries, the focus may be more on encouraging children to attend school and providing sufficient calories rather than restricting less-healthy foods, but given the double burden of under- and overnutrition in many low-income countries, these policy interventions should be considered to keep childhood obesity levels from worsening.”

Authors also suggest several possible reasons for the lack of greater policy adoption worldwide. For one, adoption could be limited by schools’ reliance on revenue generated by competitive food sales or vending agreements. There may also be a lack of awareness that food marketing is harmful or concern that the food industry could fight attempts at regulation based on rights to free speech/expression. Countries may have other, more pressing policy priorities or may not have the political will or enforcement infrastructure to enact such policies at this time.

“It’s clear that we have a big policy gap worldwide. More countries should consider adopting these policies, particularly in lower-income countries where ultra-processed foods haven’t taken over kids’ diets yet. These products absolutely should not be sold or marketed in schools.“

— DR. BARRY POPKIN

“It’s clear that we have a big policy gap worldwide,” said Popkin. “More countries should consider adopting these policies, particularly in lower-income countries where ultra-processed foods haven’t taken over kids’ diets yet. These products absolutely should not be sold or marketed in schools.”

The authors note a handful of limitations to this study, including the focus only on national-level policies. “We know that many places that have implemented some of these policies at the district, city, state, or province level,” said Emily Busey, MPH, RD, study co-author and research communications manager at the Global Food Research Program at UNC-Chapel Hill. “Given the global scope of this review, we chose to focus on national-level policies to make the search feasible for our team.”

The authors also acknowledge the challenge of finding and interpreting policies written in many different languages and the possibility that policies changed or were enacted after data collection concluded and may not be reflected in this review.

A second, companion scoping review examining national-level policies that restrict provision of categories, nutrients, or ingredients of concern in school meal programs is forthcoming.

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This research was funded by Bloomberg Philanthropies.

AUTHORS

Michelle Perry
Kayla Mardin
Grace Chamberlin
Emily Busey
Lindsey Smith Taillie
Francesca Dillman Carpentier
Barry Popkin

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Read the full study in Advances in Nutrition

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Learn more about school food environment policies.

A new study that models the combined effects of a sugar-based tax on beverages and targeted subsidies for minimally processed foods and drinks found that under these policies, low-income consumers would purchase less sugar-sweetened beverages and more fruits, vegetables, and healthier drinks, particularly in households without children.  

Researchers from the Global Food Research Program at UNC-Chapel Hill developed a model to simulate what would happen if national-level taxes on less-healthy, ultra-processed foods and beverages were used to fund subsidies for low-income households participating in food assistance programs to spend on minimally processed fruits, vegetables, healthy proteins, and unsweetened drinks. They found that this combined policy scenario would likely lead low-income households to improve the nutritional quality of their grocery purchases without increasing their overall costs or negatively impacting consumer satisfaction.

Targeted taxes are a proven, cost-effective means to reduce purchase and intake of sugary drinks, which could potentially save millions of years of life globally by reducing chronic diseases caused by excess sugar and calories. While over 60 countries and smaller jurisdictions worldwide have implemented health-focused sugary drink taxes, relatively few have earmarked the revenue raised to subsidize healthy food purchases.

In the United States, studies evaluating programs that provide additional cash benefits for food assistance participants to spend on fruits and vegetables consistently find that they increase consumers’ purchase and intake of targeted products. This new study’s findings support a novel policy approach, combining both policy types to expand low-income households’ access to additional healthier alternatives like minimally processed proteins such as beans, legumes, or unprocessed meats, and no- or low-sugar beverages.

“Our findings show that we can support healthier dietary patterns in the US by directing revenues from national taxes on ultra-processed products high in sugar, sodium and/or saturated fats towards additional benefits to help low-income households purchase more fruits, vegetables and other healthier alternatives,” said senior author Shu Wen Ng, PhD, Distinguished Scholar in Public Health Nutrition at the UNC-Chapel Hill.

“This is an equity-enhancing approach that sends a clear and consistent message to the public and the food industry on the overarching goal of improving dietary patterns and nutritional security,” added first author Pourya Valizadeh, PhD, who completed this research during a post-doctoral fellowship at UNC-Chapel Hill. “The taxes should not be primarily about generating revenue, but rather shifting the relative prices of unhealthy vs healthy foods so that lower-income families in the US can more reliably attain foods and beverages that support health.” This study’s findings could inform recent congressional bills including the “GusNIP Expansion Act” and the “Opt for Health with SNAP (OH SNAP) Close the Fruit and Vegetable Fap Act” that would levy taxes on unhealthy beverages and expand targeted subsidies beyond existing SNAP benefits for minimally processed foods and beverages to low-income households.

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This study was funded by Robert Wood Johnson Foundation Healthy Eating Research and Arnold Ventures.

AUTHORS

Shu Wen Ng
Pourya Valizadeh

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Read the full study in the American Journal of Preventive Medicine

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Learn more about
sugary drink taxes.

A new study from researchers at the Global Food Research Program at UNC-Chapel Hill and The George Institute for Global Health provides guidance for policymakers on how to identify ultra-processed foods and beverages that are also high in salt, sugar, saturated fat, or calorie-dense for regulation.

To date, food policies aimed at improving population nutrition and health have targeted foods and drinks based primarily on their nutritional profile — that is, energy-dense products high in nutrients such as sugar, sodium, or saturated or trans fats have been subject to regulations such as taxes, marketing restrictions, or front-of-package warning labels. With concern mounting over the many health harms associated with high intake of ultra-processed foods, scholars and policymakers have begun exploring how these nutrition-focused policies could target products based on degree of processing.

“Researchers in this area typically use the detailed Nova Classification criteria to identify ultra-processed products in food consumption surveys, but regulatory bodies need a simpler, more objective way to identify ultra-processed food, and ideally one that can be applied globally,” said Barry Popkin, PhD, W.R. Kenan Jr. Distinguished Professor of Nutrition at the UNC Gillings Global School of Public Health, co-director of the Global Food Research Program, and the study’s first author.

For this study, researchers compared different methods for policies to identify products that are ultra-processed and/or high in fat, sugar and/or sodium (HFSS). They used one of the objective dimension of Nova Classification: whether a product’s ingredients list includes one or more additives from 12 Codex classes which are thought to enhance hyper-palatability and are considered markers of ultra-processing. These classes include hundreds of different additives used in food processing and included in product ingredient lists. Researchers tested the ability of four different profiling approaches combining different groups of these additives with the “high in fat, sodium, sugar, or calories” (HFSS) criteria from Chile’s nutrient profiling model to capture products that were both ultra-processed and HFSS. These profiling approaches include:

1. HFSS + contains non-nutritive sweeteners
2. HFSS + contains colors/flavors
3. HFSS + non-nutritive sweeteners + colors/flavors (combination of approaches 1 & 2)
4. HFSS + 12 Codex classes of additives (flavor enhancers, colors, emulsifiers, emulsifying salts, sweeteners, thickeners, anti-foaming, bulking, carbonating, foaming, gelling and glazing agents)

Researchers applied these four approaches on a sample of over 33 million food products purchased by a representative sample of roughly 60,000 US consumers in 2020. They found that scenario 4 was most effective, under which 100% of product purchases considered ultra-processed foods under Nova Classification would be targeted for policy intervention. In addition, their findings demonstrate that policies could achieve comparable results using a more streamlined profiling model that simply combines Codex colors and flavors with HFSS criteria, which missed only 1% of ultra-processed products.

Notably, if a policy intervention such as mandatory front-of-package warning labels or restrictions on marketing used this approach, nearly 75% of products purchased by U.S. households would be subject to regulation. This highlights the predominance of foods and drinks that do not build health in the US food supply.

This study is the first to show how to operationalize healthy food policies aimed at reducing ultra-processed product consumption using the ingredients list on food packages and can help inform policymakers as they design healthy food regulations such as front of package warnings, marketing restrictions, and taxes on ultra-processed products.

These findings are timely given increasing interest in and momentum behind policies targeting ultra-processed foods. A large-scale “umbrella” review published in the British Medical Journal last month highlighted the imperative to act, finding that exposure to ultra-processed food was associated with 32 different health risks related to mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes.

“Countries around the world are currently trying to figure out how to best guide consumers away from ultra-processed foods and towards more whole or minimally processed options, whether that’s via updated dietary guidelines or policies that will incentivize purchase changes and protect consumers from harm,” said Popkin. “Our findings give policymakers one of the tools they need to implement effective policies towards this end.”

In the United States, the Food and Drug Administration is currently considering options for a front-of-package warning label, which under the current proposal would be applied only to products that contain more than 20% of certain nutrients’ recommended daily intake per serving. “Our study suggests that the FDA needs to go beyond looking at nutrients per serving and include profiling for Codex classes of additives, which number in the hundreds,” said Popkin.

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This study was funding primarily by Bloomberg Philanthropies.

AUTHORS

Barry M. Popkin
Donna R. Miles
Lindsey Smith Taillie
Elizabeth K. Dunford

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Read the full study in The Lancet Regional Health – Americas.

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Learn more about ultra-processed foods and the Nova classification system in our fact sheet:

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…

In a new perspective piece in PLOS Medicine, Global Food Research Program researchers Barry Popkin and Francesca Dillman Carpentier and alum Fernanda Mediano Stoltze reflect on the recently released World Health Organization (WHO) guideline, “Policies to protect children from the harmful impact of food marketing.”

The authors highlight several strengths of the updated guidelines, which build on the WHO’s previous recommendations published in 2010. The new guidelines extend the organization’s recommendation to restrict marketing for high-fat, -salt, or -sugar foods and drinks, calling for policies that:

• Are mandatory;
• Protect children of all ages (up to 18 years old);
• Use a government-led nutrient profile model to classify foods for restriction;
• Are “sufficiently comprehensive to minimize the risk of migration of marketing to other media, to other spaces within the same medium, or to other age groups;” and
• That restrict the persuasive power of food marketing.

The authors highlight positive updates in the newer guidelines, including:

• Explicit, strong justification for protecting children based on their fundamental rights to health, privacy, and freedom from exploitation;
• Consideration of brand marketing — a strategy that can be used to promote a brand associated with ultra-processed foods high in nutrients of concern without highlighting any one particular product; and
• Caution against policies that focus too narrowly on certain media, places, or message types (e.g., only limiting marketing during children’s television programming or only prohibiting use of explicit child appeals like cartoon characters). Rather, the guideline’s definition of marketing covers all messages to which children are exposed, preempting marketers’ attempts to get around restrictions by shifting placement or content to get around restrictions and continue reaching children.

Drs. Dillman Carpentier, Mediano Stoltze, and Popkin also outline some key areas where they thought the new WHO guideline fall short. They recommend a stronger argument for policy comprehensiveness (i.e., focusing on eliminating rather than limiting exposure) and more consideration for increasing use of health marketing (e.g., greenwashing or social responsibility branding). They also outline flaws in how the guideline assessed available evidence on the effectiveness of marketing policies and how food marketing affects children, which limited the strength of policy recommendations.

Finally, the authors note that countries should consider limiting marketing for all ultra-processed products, in addition to nutritionally poor foods, to fully protect all children from unhealthy food marketing and its influence on their health trajectories.

While the WHO has been recommending regulations to limit food marketing and protect children from its harms for over a decade, countries have been slow to adopt such policies, and those that have been implemented are predominantly narrow in scope.¹ The new guidelines, in addition to evidence of early successes following Chile’s relatively comprehensive marketing laws,^2-4 support the imperative for bold, worldwide action to better protect children and population health through statutory regulation of food marketing.

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¹ Lindsey Smith Taillie, Emily Busey, Fernanda Mediano Stoltze, Francesca Renee Dillman Carpentier, Governmental policies to reduce unhealthy food marketing to children, Nutrition Reviews, Volume 77, Issue 11, November 2019, Pages 787–816, https://doi.org/10.1093/nutrit/nuz021

² Dillman Carpentier, F. R., Smith Taillie, L., Correa, T. (2023). “Chile’s Comprehensive Food Policy Offers Global Lesson in Tackling Unhealthy Foods.” from https://healthpolicy-watch.news/chiles-comprehensive-food-policy/.

³ Dillman Carpentier, F.R., Mediano Stoltze, F., Reyes, M. et al. Restricting child-directed ads is effective, but adding a time-based ban is better: evaluating a multi-phase regulation to protect children from unhealthy food marketing on television. International Journal of Behavioral Nutrition and Physical Activity 20, 62 (2023). https://doi.org/10.1186/s12966-023-01454-w

⁴ Mediano Stoltze, F., Barker, J., Kanter, R., Corvalán, C., Reyes, M., Taillie, L., & Dillman Carpentier, F. (2018). Prevalence of child-directed and general audience marketing strategies on the front of beverage packaging: The case of Chile. Public Health Nutrition, 21(3), 454-464. doi:10.1017/S1368980017002671

AUTHORS

Francesca Dillman Carpentier
W. Horace Carter Distinguished Professor, Hussman School of Journalism and Media, UNC-Chapel Hill

Fernanda Mediano Stoltze
Assistant professor, School of Psychology, Pontificia Universidad Catolica de Chile

Barry Popkin
W. R. Kenan Jr. Distinguished Professor, Department of Nutrition, UNC-Chapel Hill

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RESOURCES

Read more about the evidence for restricting marketing for non-essential foods and drinks high in sugar, salt, saturated or trans fats, or calorie density.

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Compare existing policies around the world aimed at restricting unhealthy food marketing to children.