Understanding of front of package nutrition labels: Guideline daily amount and warning labels in Mexicans with non-communicable diseases

Sagaceta-Mejía, Janine; Tolentino‐Mayo, Lizbeth; Cruz‐Casarrubias, Carlos; Nieto, Claudia; Barquera, Sı́món

doi:10.1371/journal.pone.0269892

Cited by 16 publications

(7 citation statements)

References 53 publications

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“…In line with our results regarding the association between BMI category and WLs, Sagaceta et al (2019) showed that the WLs help Mexicans with overweight and obesity, as well as other non-communicable chronic diseases to classify unhealthy foods products more appropriately compared with GDA [42]. Our results are also in line with reports showing that the presence of WLs on food packages was associated with lower perceptions of healthfulness and purchasing intentions of Chilean parents [20,43].…”

Section: Discussionsupporting

confidence: 92%

Self-reported decreases in the purchases of selected unhealthy foods resulting from the implementation of warning labels in Mexican youth and adult population

Contreras-Manzano,

White,

Nieto

et al. 2023

Preprint

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BackgroundFront-of-package nutritional warning labels (WLs) are designed to facilitate identification and selection of healthier food choices. We assessed self-reported changes in purchasing different types of unhealthy foods due to WLs in Mexico and the association between the self-reported reductions in purchases of sugary beverages and intake of water and sugar-sweetened beverages.MethodsData came from 14-17 year old youth (n=1,696) and adults ≥18 (n=7,775) who participated in the Mexican arm of the 2020-2021 International Food Policy Study, an annual repeat cross-sectional online survey. Participants self-reported whether the WLs had influenced them to purchase less of each of ten unhealthy food categories due to WLs. Among adults, a 23-item Beverage Frequency Questionnaire was used derive past 7-day intake of water and sugary beverages analyzed to determine the relationship between self-reported reductions in purchasing sugary drinks due to the WLs. Multilevel mixed-effects logistic regression models were fitted to estimate the percentage of participants who self-reported reducing purchases within each food group, and overall. Sociodemographic characteristics associated with this reduction were investigated as well.ResultsOverall, 44.8% of adults and 38.7% of youth reported buying less of unhealthy food categories due to the implementation of WL, with the largest proportion reporting decreased purchases of cola, regular and diet soda. A greater impact of WLs on the reported purchase of unhealthy foods was observed among the following socio-demographic characteristics: females, individuals who self-identified as indigenous, those who were overweight, individuals with lower educational levels, those with higher nutrition knowledge, households with children, and those with a significant role in household food purchases. In addition, adults who reported higher water intake and lower consumption of sugary beverages were more likely to report reduced purchases of sugary drinks due to the WLs. Adults who reported greater water intake and lower sugary beverages intake were significantly more likely to report buying fewer sugary drinks due to the WLs.ConclusionOur findings suggest that implementation of WLs has reduced purchases of unhealthy foods in Mexico. These results underscore the positive impact of the labeling policy particularly in subpopulations with lower levels of education and among indigenous adults.

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Section: Discussionsupporting

confidence: 92%

Self-reported decreases in the purchases of selected unhealthy foods resulting from the implementation of warning labels in Mexican youth and adult population

Contreras-Manzano,

White,

Nieto

et al. 2023

Preprint

Self Cite

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“…Knowing that traffic lights are better ignored for some product groups undermines the trust and thus the impact of such oversimplified systems. Similarly, front-of-package warnings, such as those employed in Mexico ( 68 ), have not been successful and are often ignored by consumers.…”

Section: Methodsmentioning

confidence: 99%

The Metabolic Matrix: Re-engineering ultraprocessed foods to feed the gut, protect the liver, and support the brain

Harlan

Gow

Kornstädt³

et al. 2023

Front. Nutr.

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Ultraprocessed food is established as a metabolic disruptor acting to increase adiposity, reduce mitochondrial efficiency, drive insulin resistance, alter growth, and contribute to human morbidity and mortality. Consumer packaged goods (CPG) companies are beginning to understand the detrimental impact of the food they market, and have employed substitution strategies to reduce salt, sugar, and fat. However, the harms of ultraprocessed foods are far more complex than any single component, and are not ameliorated by such simple substitutions. Over the past 2 years, the authors have worked with the Kuwaiti Danish Dairy Company (KDD) to conduct a comprehensive scientific evaluation of their entire commercial food and beverage portfolio. Assay of the macronutrients, micronutrients, additives, and toxins contained in each of their products was undertaken to determine the precise nature of each product’s ingredients as well as the health impacts of processing. The authors formed a Scientific Advisory Team (SAT) and developed a tiered “Metabolic Matrix” founded in three science-based principles: (1) protect the liver, (2) feed the gut, and (3) support the brain. The Metabolic Matrix categorizes each product and provides the criteria, metrics, and recommendations for improvement or reformulation. Real-time consultation with the KDD Executive and Operations teams was vital to see these procedures through to fruition. This scientific exercise has enabled KDD to lay the groundwork for improving the health, well-being, and sustainability of their entire product line, while maintaining flavor, economic, and fiscal viability. This process is easily transferrable, and we are sharing this effort and its approaches as a proof-of-concept. The key aim of our work is to not only make ultraprocessed food healthier but to urge other food companies to implement similar analysis and reformulation of their product lines to improve the metabolic health and well-being of consumers worldwide.

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“…On the contrary, civil society organizations and PAHO were strong advocates for the policy, and most health Ministers and Presidents supported its approval. After all the challenges faced, Peru successfully defined the black octagons as the nutritional warnings' design, which has proven to be easier to understand by consumers [81] and appears to produce the largest public health benefits [82].…”

Section: Discussionmentioning

confidence: 99%

Design and approval of the nutritional warnings’ policy in Peru: Milestones, key stakeholders, and policy drivers for its approval

Diez-Canseco¹,

Cavero²,

Cano³

et al. 2023

PLOS Glob Public Health

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Nutritional warnings are used as a public health strategy to address obesity. Peru approved in 2013 and implemented in 2019 a law requiring nutritional warnings on the marketing and packaging of processed foods high in sugar, sodium, saturated fat, and containing trans-fat. The complexity behind the design and approval of these policies over six years provides unique learnings, that inform the obesity prevention context, especially when proposed policies face strong opposition from powerful stakeholders. Our study aims to describe the milestones and key stakeholders’ roles and stances during the nutritional warnings policy design in Peru, and to identify and analyze the main drivers of policy change that explain its approval. In 2021, interviews were conducted with 25 key informants closely involved in its design. Interviews were analyzed using the Kaleidoscope Model as a theoretical framework. Relevant policy documents and news were also analyzed. Milestones for this policy included the approval of the Law, Regulation, and Manual. Policy supporters were mainly from Congress, civil society advocates, and Health Ministers. Opponents came from Congress, ministries linked to the economic sector, the food industry, and media. Across the years, warnings evolved from a single text, to traffic lights, to the approved black octagons. Main challenges included the strong opposition of powerful stakeholders, the lack of agreement for defining the appropriate evidence supporting nutritional warning parameters and design, and the political instability of the country. Based on the Kaleidoscope Model, the policy successfully targeted a relevant problem (unhealthy eating decisions) and had powerful advocates who effectively used focusing events to reposition the warnings in the policy agenda across the years. Negotiations weakened the policy but led to its approval. Importantly, government veto players were mostly in favor of the policy, which enabled its final approval despite the strong opposition.

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Understanding of front of package nutrition labels: Guideline daily amount and warning labels in Mexicans with non-communicable diseases

Cited by 16 publications

References 53 publications

Self-reported decreases in the purchases of selected unhealthy foods resulting from the implementation of warning labels in Mexican youth and adult population

Self-reported decreases in the purchases of selected unhealthy foods resulting from the implementation of warning labels in Mexican youth and adult population

The Metabolic Matrix: Re-engineering ultraprocessed foods to feed the gut, protect the liver, and support the brain

Design and approval of the nutritional warnings’ policy in Peru: Milestones, key stakeholders, and policy drivers for its approval

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