Changes in children’s and adolescents’ dietary intake after the implementation of Chile’s law of food labeling, advertising and sales in schools: a longitudinal study

Abstract

Background In June 2016, a comprehensive food policy was implemented in Chile that included front-of-package warning labels on key nutrients of concern (total sugars, added saturated fats, sodium, and calories), child-directed food advertisement bans, and school regulations. The policy was implemented in 3 phases from 2016 to 2019 and the primary objective was to improve children’s food environments. This study’s objective was to assess changes in child and adolescent intake of key nutrients of concern (total sugars, saturated fats, and sodium) at school after the initial implementation of Chile’s Law of Food Labeling and Advertisement. Methods Longitudinal study of 349 children from the Food Environment Chilean Cohort (FECHIC) and 294 adolescents from the Growth and Obesity Cohort Study (GOCS). Data were from single 24-hour dietary recalls collected from 2016 to 2019. Fixed-effects models stratified by school, home, and other locations compared nutrient consumption in each year to consumption at the pre-policy 2016 baseline. Nutrient intakes are expressed as percent of total energy. Results Compared to 2016 (pre-policy), total sugars consumed by children at school decreased 4.5 [-8.0, -0.9] percentage points (pp) and 11.8 [-15.4, -8.3] pp in 2018 and 2019 respectively. In 2019, children’s saturated fats and sodium intake at school also decreased (1.1 [-1.9, -0.2] pp and 10.3 [-18.1, -2.5] mg/100 kcal respectively). Likewise, in adolescents, total sugars and saturated fats consumed at school decreased in 2018 (5.3 [-8.4, -2.2] pp and 1.5 [-2.7, -0.3] pp respectively). However, consumption of key nutrients of concern at other locations increased after implementation of the policy. Conclusions After initial implementation of Chile’s Labeling Law, intake of most key nutrients of concern significantly declined at school. However, we found evidence of compensatory behavior in out-of-school settings. Further research is needed to evaluate what other actions are needed to impact overall diets in the long term both at schools and out of school.

Evaluation of the Nutritional Quality of Chinese Processed Meat Products: Comparison of Two Nutrient Profile Models

“…In Chile, if the content of CNs associated with NCDs exceeded predetermined criteria, the black octagonal FOPWL must be displayed on the front of the product packaging [ 35 , 36 ]. Schnettler et al [ 43 , 44 ] assessed the influence of consumers’ perceived healthfulness, purchase intention, and willingness to pay for reformulated frankfurters.…”

“…The third-phase threshold was implemented in 2019. When the content of energy, total sugar, saturated fat, and sodium in products exceed the threshold, the front of the packaging must be labeled with a black octagonal FOPWL [ 35 , 36 ].…”

Predicted impact of banning nonessential, energy-dense food and beverages in schools in Mexico: A microsimulation study

“…Three years after the intervention, total sugars consumed by children at school decreased 11.8 percentage point (pp), saturated fats decreased 1.1 pp, and sodium decreased 10.3 mg/100 kcal. In adolescents, total sugars and saturated fats consumed at school decreased 5.3 pp and 1.5 pp, respectively [17]. In 2022, the Chilean Ministry of Education reported that school-age children decreased their prevalence of obesity by 4.8% relative to 2021 [18], which suggests promising results for countries implementing similar interventions, such as Mexico.…”

Decreases in purchases of energy, sodium, sugar, and saturated fat three years after implementation of the Chilean Food Labelling and Marketing Law

“…The Chilean regulations were implemented in three phases (2016, 2018, and 2019). Initial evaluations of the Chilean policy after the first phase found that it was associated with changes in the food environment, including reductions of nutrients of concern in the food supply (e.g., energy, sugar, sodium, and saturated fat) 2 and reductions in children's exposure to unhealthy food advertising and marketing [3][4][5][6][7] , improvements in mothers' understanding of unhealthy foods and use of the warning labels 8 , reductions in purchases of foods and drinks carrying the warning label [9][10][11] , improvements in the nutritional quality of foods available in schools 12 , and improvement in children's dietary intake 13 . However, much less is known about policy-linked changes in dietary behavior over a longer time period.…”