Effects of front-of-package caffeine and sweetener disclaimers in Mexico: cross-sectional results from the 2020 International Food Policy Study

Abstract

Objective: Front-of-pack warning labels introduced in Mexico in 2020 included disclaimers that caution against allowing children to consume products with non-sugary sweeteners and caffeine. We examined the awareness and use of the disclaimers among Mexican adults and youth one month after the regulation was implemented. We also investigated their impact on the perceived healthfulness of industrialized beverages designed for children. Design: Data on the awareness and use of the disclaimers were analyzed. Two between-subjects experiments examined the effect of a sweetener disclaimer (Experiment 1, youth and adults) or a caffeine disclaimer (Experiment 2, only adults) on the perceived healthfulness of industrialized beverages. Interactions between experimental conditions and demographic characteristics were tested. Setting: Online survey in 2020. Participants: Mexican adults (≥18 years, n=2,108) and youth (10-17 years, n=1,790). Results: Most participants (>80%) had seen the disclaimers at least rarely, and over 60% used them sometimes or frequently. The sweetener disclaimer led to a lower perceived healthfulness of a fruit drink (Adults: 2.74±1.44; Youth: 2.04±0.96) compared to the no-disclaimer condition (Adults: 3.17±1.54; Youth: 2.32±0.96) (t’s:>4.0, P-values: <0.001). This effect was larger among older adults and male youth. The caffeine disclaimer did not affect adult’s perceived healthfulness of a caffeinated drink (t=0.861, p value=0.3894). Conclusions: There was high awareness and use of the sweeteners and caffeine disclaimers shortly after the warning labels were implemented. The sweetener disclaimer appears to be helping consumers modify their perceptions regarding industrialized beverages for children. Findings may help decision-makers improve the regulation and better target communication strategies.

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

“…In our study, participants with lower educational level, lower income adequacy and indigeneity status self-reported a greater reduction in the purchase of unhealthy foods because of the WLs. These population groups have a disproportionate burden of noncommunicable diseases and lower access to healthy and nutritious foods [39]. Results of this study suggest that WLs may aid in decreasing health disparities.…”

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

“…Furthermore, in addition to the traditional WLs indicating excess content of critical nutrients, many sugary drinks in Mexico are also required to display the two rectangle-shaped warning legends related to sweeteners and caffeine content [38]. These additional labels, which are generally less applicable to other food categories, may contribute to changes in the perceived healthiness of cola beverages and artificially sweetened drinks [38,39]. For example, the perceived impact of WLs on sugary fruit drink purchases was significantly lower than on diet soda purchases among youth (although no difference was observed among adults) [39].…”

“…These additional labels, which are generally less applicable to other food categories, may contribute to changes in the perceived healthiness of cola beverages and artificially sweetened drinks [38,39]. For example, the perceived impact of WLs on sugary fruit drink purchases was significantly lower than on diet soda purchases among youth (although no difference was observed among adults) [39]. In line with the former, data from ENSANUT 2021 suggested that one year after the enactment of WLs in Mexico, 21.6% of adults identified excess calories in cola beverages, 82.3% identified excess sugars, 22.4% identified the caffeine warning, and 11.8% identified the sweeteners warning [32].…”

“…Indeed, evidence from other countries suggests that fruit drinks may have replaced soda as the most consumed sugar-sweetened beverage among children [46]. In Mexico, sugary fruit drinks typically contain WLs for excess calories and sugars, while soda is additionally labeled with warning legends for sweeteners and/or caffeine (cola sodas) [39]. Future analyses should investigate substitution effects to fully understand the impact of WLs.…”