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Prevention: Food labelling

Nutrient warning labels

Last updated 16-07-2020

Front-of-pack nutrient warning labels are being introduced around the world, following their introduction in Chile in 2016. Warning labels are applied to food and drink products that exceed thresholds for various risk nutrients. Evidence is building about the effect of Chile’s nutrient warning labels in promoting healthy diets.

Key Evidence

01

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

02

Nutrient warning labels may offer some advantages over other front-of-pack labelling schemes such as positive endorsements or summary indicators

03

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.

Nutrient warning labels on Chile cereal
Source: Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Mexico

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

Nutrient warning labels are due to be introduced in Colombia in 202213 and are under active consideration in in Brazil,14 Argentina,15 Canada16 and South Africa.2

Israel nutrient warning labels for products high in sugar, salt and saturated fat

References

1. Reyes M, Garmendia ML, Olivares S, Aqueveque C, Zacarías I & Corvalán C. (2019). Development of the Chilean front-of-package food warning label. BMC Public Health, 19(1), 906. doi: 10.1186/s12889-019-7118-1
2. Taillie LS, Hall MG, Popkin BM, Ng SW & Murukutla N. (2020). Experimental Studies of Front-of-Package Nutrient Warning Labels on Sugar-Sweetened Beverages and Ultra-Processed Foods: A Scoping Review. Nutrients, 12(2), 569.
3. Shahid M, Neal B, Jones A. Uptake of Australia’s Health Star Rating System 2014–2019. Nutrients. 2020; 12(6):1791.
4. Correa T, Fierro C, Reyes M, Dillman Carpentier FR, Taillie LS & Corvalan C. (2019). Responses to the Chilean law of food labeling and advertising: exploring knowledge, perceptions and behaviors of mothers of young children. The international journal of behavioral nutrition and physical activity, 16(1), 21. doi: 10.1186/s12966-019-0781-x
5. Taillie LS, Reyes M, Colchero MA, Popkin B & Corvalán C. (2020). An evaluation of Chile's Law of Food Labeling and Advertising on sugar-sweetened beverage purchases from 2015 to 2017: A before-and-after study. PLOS Medicine, 17(2), e1003015-e1003015.
6. Michail N. (2019, 17-05-2019). Peru: Nutrition warnings become mandatory, foodnavigator-latam.com. Retrieved from https://www.foodnavigator-latam.com/Article/
7. Michail N. (2020, 24-02-2020). Warning labels set to enter into force in Uruguay: is your product compliant?, foodnavigator-latam.com. Retrieved from https://www.foodnavigator-latam.com/Article/
8. Kelly B and Jewell J. What is the evidence on the policy specifications, development processes and effectiveness of existing front-of-pack food labelling policies in the WHO European Region? , Copenhagen, Denmark: WHO Regional Office for Europe, 2018. Available from: http://www.euro.who.int
9. Kanter R, Reyes M, Swinburn B, Vandevijvere S & Corvalán C. (2018). The Food Supply Prior to the Implementation of the Chilean Law of Food Labeling and Advertising. Nutrients, 11(1), 52.
10. Larrañaga, A. (2020, 30-03-20). Obesity in Mexico: The challenging case of warning labels, NCD Alliance blog. Retrieved from https://ncdalliance.org/news-events/
11. United States Department of Agriculture. (2020). Mexico: Implementation of the New Mexican Regulation for Front-of-Package Nutrition Label. Retrieved from: https://www.fas.usda.gov/data
12. White M & Barquera S. (2020). Mexico Adopts Food Warning Labels, Why Now? Health Systems & Reform, 6(1), e1752063.
13. Krizanovic P. (2020, 05-03-2020). Columbia unveils new nutrition warning labels, just-food.com. Retrieved from https://www.just-food.com/
14. Michail N. (2019, 18-09-19). ANVISA unveils Brazil's nutrition warning label, foodnavigator-latam.com. Retrieved from https://www.foodnavigator-latam.com/
15. Michail N. (2019, 25-11-2019). Argentinian draft bill calls for mandatory nutrition label, foodnavigator-latam.com. Retrieved from https://www.foodnavigator-latam.com/
16. Government of Canada. (2019). Consultation on proposed front-of-package labelling Retrieved 01-05-2020, from https://www.canada.ca/en/