Background In Mexico, the inclusion of a Front-of-Pack Label in the Official Mexican Standard-051 (NOM-051 for its Spanish acronym) has been widely discussed for years by different stakeholder groups. In 2019, the NOM-051 modification project was proposed, which included front-of-pack warning labels. To be modified, it went through a public consultation period where stakeholders sent their comments to be reviewed and considered. The purpose of this study was to analyze the perspectives of key stakeholders during the public consultation of the NOM-051 modification project in order to understand their positions and their effect on the final public policy. Methods To analyze perspectives, the 795 comments received on the website of the National Commission for Regulatory Improvement were analyzed. Identity, expectations, and demands were identified from each comment using content analysis in NVivo. In addition, frequencies and percentages were obtained. To identify the public consultation’s effect on the modification project, we compared the most significant changes made to the NOM-051 modification project with the outstanding demands of the stakeholders. Results 56% of the comments were against the NOM-051 modification project. Industry and Business Interest Non-Governmental Organizations were against it, they considered that their revenues and profits would be affected. Public Interest Non-Governmental Organizations, academy and health professionals were in favor, they expected that eating habits would improve and demanded the front-of-pack warning label suggested in the modification proposal be maintained. The published regulation (NOM-051) demonstrates that the stakeholders’ main demands were considered in the policy development and their involvement was fundamental for the process. Conclusions The comments against the NOM-051 modification project were consistent with the literature, indicating that food industry stakeholders use all possible strategies to interfere in public health policies. The main issues used by the food industry to discredit the NOM-051 modification project coincide with those used in other countries to stop public health policies and with those used by the tobacco industry to avoid market regulations. On the other hand, those in favor looked after the interests of the Mexican population.

Background In Mexico, the inclusion of a front-of-pack label in the Official Mexican Standard 051 (NOM-051 for its Spanish acronym) has been widely discussed for years by different stakeholder groups. In 2019, the NOM-051 modification project was proposed, which included front-of-pack warning labels. To be modified, it underwent a public consultation period where stakeholders sent their comments to be reviewed and considered. The purpose of this study was to analyse the stakeholders’ perspectives during the public consultation of the NOM-051 modification project. Methods To assess perspectives, the 795 comments available on the National Commission for Regulatory Improvement website were analysed. Identity, expectations and demands were identified from each comment using content analysis in NVivo. In addition, frequencies and percentages were obtained. Results Fifty-six percent of the comments were opposed to the NOM-051 modification project. Industry and business interest nongovernmental organizations were against it; they considered that their revenues and profits would be affected. Public interest nongovernmental organizations, academia and health professionals were in favour, stating that the changes proposed are fundamental to informing consumers and improving food choices, and an essential factor in reducing the prevalence of overweight and obesity. Stakeholders in favour expected that eating habits would improve, and demanded that the front-of-pack warning label suggested in the modification proposal be maintained. Conclusions The comments opposed to the NOM-051 modification project were consistent with the literature, indicating that food industry stakeholders use all possible arguments to interfere in public health policies. The main issues used by the food industry to discredit the NOM-051 modification project coincide with those used in other countries to stop public health policies and with those used by the tobacco industry to avoid market regulations. On the other hand, those in favour looked after the interests of the Mexican population.