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Cited by 274Consumer Attitudes and Food LabelingGlobal Public Health Policies and EpidemiologyObesity, Physical Activity, Diet

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Changes in food purchases after the Chilean policies on food labelling, marketing, and sales in schools: a before and after study

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Taillie, Lindsey Smith, Bercholz, Maxime, Popkin, Barry, Reyes, Marcela, Colchero, M Arantxa, Corvalán, Camila·2021·The Lancet Planetary Health
DOI 10.1016/s2542-5196(21)00172-8PMC PMC8364623
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Abstract

BACKGROUND: In 2016, Chile implemented a unique law mandating front-of-package warning labels, restricting marketing, and banning school sales for products high in calories, sodium, sugar, or saturated fat. We aimed to examine changes in the calorie, sugar, sodium, and saturated fat content of food and beverage purchases after the first phase of implementation of this law. METHODS: This before and after study used longitudinal data on food and beverage purchases from 2381 Chilean households from Jan 1, 2015, to Dec 31, 2017. Nutrition facts panel data from food and beverage packages were linked to household purchases at the product level using barcode, brand name, and product description. Nutritionists reviewed each product for nutritional accuracy and categorised it as high-in if it contained added sugar, sodium, or saturated fat and exceeded phase 1 nutrient or calorie thresholds, and thus was subject to the labelling, marketing, and school regulations. Using fixed-effects models, we examined the mean nutrient content (overall calories, sugar, saturated fat, and sodium) of purchases in the post-policy period compared to a counterfactual scenario based on pre-policy trends. FINDINGS: Compared with the counterfactual scenario, overall calories purchased declined by 16·4 kcal/capita/day (95% CI -27·3 to -5·6; p=0·0031) or 3·5%. Overall sugar declined by 11·5 kcal/capita/day (-14·6 to -8·4; p<0·0001) or 10·2%, and saturated fat declined by 2·2 kcal/capita/day (-3·8 to -0·5; p=0·0097) or 3·9%. The sodium content of overall purchases declined by 27·7 mg/capita/day (-46·3 to -9·1; p=0·0035) or 4·7%. Declines from high-in purchases drove these results with some offset by increases in not-high-in purchases. Among high-in purchases, relative to the counterfactual scenario, there were notable declines of 23·8% in calories purchased (-49·4 kcal/capita/day, 95% CI -55·1 to -43·7; p<0·0001), 36·7% in sodium purchased (-96·6 mg/capita/day,-105·3 to -87·8; p<0·0001), and 26·7% in sugar purchased (-20·7 kcal/capita/day, -23·4 to -18·1; p<0·0001). INTERPRETATION: The Chilean phase 1 law of food labelling and advertising policies were associated with reduced high-in purchases, leading to declines in purchased nutrients of concern. Greater changes might reasonably be anticipated after the implementation of phases 2 and 3. FUNDING: Bloomberg Philanthropies, International Development Research Center, and Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health.

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Metadata

Authors
Taillie, L. S., Bercholz, M., Popkin, B., Reyes, M., Colchero, M. A., & Corvalán, C.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Instituto Nacional de Salud Pública (MX)
  • University of Chile (CL)
Corresponding author
Corvalán, Camila
ORCID
Venue
The Lancet Planetary Health
Publisher
Elsevier BV
Published
2021-08
Volume
5
Issue
8
Pages
e526-e533
ISSN
2542-5196 (ISSN-L)
DOI
10.1016/s2542-5196(21)00172-8
PMC
PMC8364623
OpenAlex
W3187973817
Cited by
274
References
26
Citations by year
2026: 47 · 2025: 62 · 2024: 73 · 2023: 56 · 2022: 30 · 2021: 5
FWCI
35.54
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Planetary Health (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Greater South Information System
Funders
  • National Institutes of Health
  • Bloomberg Philanthropies
  • International Development Research Centre
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Consumer Attitudes and Food Labeling
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
front-of-package warning labels, food marketing restrictions, nutrition policy, household food purchasing, energy intake, sugar consumption, sodium intake, saturated fat intake, nutrition facts panel, nutrition labeling, counterfactual scenarios, school meals
MeSH terms
Child, Chile, Food Labeling, Humans, Schools, Marketing, Policy

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