User:NUstudent1316/Food labelling and advertising law (Chile)/Bibliography

Background (expanding upon)
Prior to the law's enactment, poor diet and high body mass index were the leading causes of premature death and disability in Chile.

History of Front of Package Warning Label
In an effort to combat childhood obesity, the World Health Organization encourages implementing a three pronged approach to promote health. Their suggestions include mandating front-of-package warning labels (FOPWL), banning marketing of foods with a FOPWL to children and prohibiting selling these products in schools. In 1993, Finland was the first country to enact a similar law, issuing a front of package warning label on sodium rich products. Chile is the first country to adapt all three recommendations outlined by the WHO.

3 Pillars of the Law

 * 1) Labels which exceed the recommended amount of a particular nutrient, including high in salt, sugar, sodium and saturated fat must be displayed at the front of the package as “high in”.
 * 2) Schools are prohibited from selling foods with a FOPWL.
 * 3) These products cannot be advertised to children under the age of 14 through any media channels nor can they utilize marketing tactics that appeal to children - such as school appeals and relevant celebrities and figures to the demographic.

Impact in Purchasing and Perception
A strong level of awareness exists for Chile’s food labeling law. A majority of Chileans were able to state the purpose of the law and its effectiveness, but few were able to address what the guideline daily amount meant. The Lancet compared pre and post policy enactment on food and beverage purchases in Chile. They found calories in purchased foods decreased by 3.5 percent overall. The total sum amount of sugar and saturated fats in products decreased by 10.2 and 3.9 percent retrospectively. The Lancet concluded that the law's enactment resulted in a significant decrease in purchase of food with labels ‘high in’ a nutrient. However, a review of the literature from the British Food Journal notes that after the implementation of the first stage, there was no correlation found between the law's enactment and a change in obesity rates. The researchers suggest continued studies after the third law's implementation to discover if there is a statistically significant effect.

The International Journal of Behavioral Nutrition and Physical Activity conducted an analysis of the Chilean Law’s impact, specifically focusing on mothers with school aged children. Mothers who participated in the focus groups had children between the ages of 2-14 as a predeterminate to participate. In all focus groups mothers were both aware of the policy as well as its overarching goal to reduce childhood obesity. Some of the mothers reported that the policy has “uncovered” what constitutes as healthy, and has encouraged many of them to change their shopping habits accordingly. Mothers reported a mixed result on how the warning labels have influenced their shopping habits. Some report no impact, while others utilize it as a quick shortcut while shopping. Another group reported paying very close attention to the warnings, particularly those of a middle and high socioeconomic status. Further, another study found that 78.5 percent of individuals surveyed reported that the front of package warning labels swayed their purchasing decisions. Perception of highly processed foods has encouraged many mothers to purchase higher quantities of natural foods.

Repercussions in Schools
In a focus group including mothers with school aged children, they self-reported that schools have become advocates for healthy eating, replacing unhealthy food with fresh fruits and vegetables. Previous school events centered around eating an unhealthy treat, such as cookies or cakes, have been replaced with healthy alternatives. Similarly, the British Food Journal found that over a two year period, fruit and vegetable availability in schools increased from 0.7 percent in 2014 to 3.2 percent in 2016. Further, food products with nutrients that exceeded the recommended thresholds in schools decreased in availability from 90.4 percent to 15 percent from 2014 to 2016.

Critique of the Law
Pushback has been voiced against the law, with many individuals reporting message fatigue. Message fatigue and overexposure has been found to dilute the ability of public health campaigns and hamper respondents ability to digest messages. Critics also argue that the government should go further and tax unhealthy food while subsidizing healthy food to make healthy eating accessible to all socio-economic groups. They believe this change could address a significant barrier to healthy eating while making the law far more effective. Further, some mothers claimed they felt the policy infringed upon their freedom as they were no longer allowed to give their children junk food to school, as it would likely be taken away from them.