In Chile, black warning labels shaped like stop signs are required for packaged food and drinks exceeding limits for sugar, salt, saturated fat or calories
Nutrient warning labels may offer some advantages over other front-of-pack labelling schemes such as positive endorsements or summary indicators
Countries including Peru, Uruguay, Israel and Mexico are due to introduce or have introduced nutrient warning labels
Mandatory front-of-pack nutrient warning labels have been introduced, announced or are under active consideration by governments around the world, following their successful implementation in Chile in 2016. In Chile, black warning labels shaped like stop signs are required for packaged food and drinks exceeding limits for sugar, salt, saturated fat or calories. For each nutrient exceeded, products are required to carry a stop sign warning, meaning some products can carry up to four labels.1 The law is also integrated with restrictions on marketing to children and foods for sale in preschools and schools. This means that foods carrying stop sign warnings are not eligible to be marketed to children or sold in these settings.
By signalling that a product is unhealthy, nutrient warning labels may offer some advantages over other front-of-pack labelling schemes such as positive endorsements (e.g. ‘ticks’) or summary indicators such as Australia’s Health Star Rating system. The types of label differ in their objectives – Health Stars attempt to provide an overall rating on a spectrum by combining both positive and negative food components.2 This has led to some concern, for example, that a breakfast cereal high in added sugar can continue to score highly because it is low in other risk nutrients such as saturated fat and sodium; or because risk nutrients can be offset by fibre and protein. In particular, in its voluntary form, there is very little evidence that Health Stars are being applied voluntarily on low-scoring products by most companies, meaning that consumers are missing the benefit of this information to guide them away from unhealthy choices.3 By contrast, nutrient warning labels clearly signal the presence (or absence) of high levels of risk nutrients. In doing so, they are specifically designed to highlight unhealthy choices only.
Evidence is emerging about the effect of Chile’s nutrient warning labels in promoting healthy diets. For example, focus groups with mothers of young children a year after the introduction of the warning labels found high awareness of the new laws and widespread understanding that products with more labels were less healthy than products with fewer labels.4 While use of the warning labels in making purchasing decisions was mixed, mothers reported that their children (particularly younger children) were asking for healthier foods due to schools actively promoting behaviour change. This went beyond sales restrictions in schools for “high in” products, with teachers encouraging students to bring healthy snacks for morning tea and special events. Many mothers said there had been a shift towards healthier eating, which may lead to changes in social norms.
Another Chilean study used national data on household food purchases to compare purchases of sugary drinks before and after the introduction of the new regulations for “high in” products.5 Researchers compared beverage purchases after the introduction of these regulatory measures to expected purchases had they not been implemented, based on pre-implementation trends. They found that purchases of “high in” beverages decreased by 24%, with similar reductions in purchases seen across households with high and low levels of education. The effect was greater than that seen following the introduction of stand-alone sugary drink reduction policies in other South American countries, such as taxes. Researchers could not separate out the effects of the different components of the new measures (labelling, marketing restrictions, sales bans in preschools and schools) in achieving the reduction.
Besides Chile, Peru, Uruguay and Israel have also introduced nutrient warning labels. In Peru, laws came into effect in June 2019 requiring octagonal, black and white warning labels on all processed food and drinks that exceed thresholds for salt, sugar or saturated fat; and for any products containing trans fats.6 In Uruguay, laws came into effect in March 2020 requiring similar black and white, octagonal warning labels for products that exceed thresholds for salt, sugar, fat or saturated fat.7
In Israel, the government has introduced red warning labels with text and images for products high in sugar, salt and saturated fat. It took a two-phased approach to threshold criteria, giving the food industry until January 2020 to implement the new labels with a second set of stricter maximum thresholds due to come into effect in January 2021.8 (The Chilean Government also took a phased approach to introducing warning labels).9
In Mexico, regulatory authorities in 2019 approved modifications to labelling standards requiring food and beverages to carry black and white, octagonal warning labels if they exceeded thresholds for sugar, sodium, fats and calories.10 Products with one or more warning labels cannot contain any elements directed towards children such as characters, pictures of celebrities or athletes, games or interactive elements.11 A legal fight with industry groups led to a provisional suspension of the new regulation in March 2020, however this was quickly lifted12 and the regulation is now due to be implemented from October 2020.11