Changes in the amount of nutrient of packaged foods and beverages after the initial implementation of the Chilean Law of Food Labelling and Advertising: A nonexperimental prospective study

Autoři: Marcela Reyes aff001;  Lindsey Smith Taillie aff002;  Barry Popkin aff002;  Rebecca Kanter aff003;  Stefanie Vandevijvere aff004;  Camila Corvalán aff001
Působiště autorů: Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile aff001;  Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America aff002;  Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile aff003;  Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand aff004;  Scientific Institute of Public Health (Sciensano), Department of Epidemiology and Public Health, Brussels, Belgium aff005
Vyšlo v časopise: Changes in the amount of nutrient of packaged foods and beverages after the initial implementation of the Chilean Law of Food Labelling and Advertising: A nonexperimental prospective study. PLoS Med 17(7): e32767. doi:10.1371/journal.pmed.1003220
Kategorie: Research Article
doi: 10.1371/journal.pmed.1003220



In June 2016, the first phase of the Chilean Food Labelling and Advertising Law that mandated front-of-package warning labels and marketing restrictions for unhealthy foods and beverages was implemented. We assess foods and beverages reformulation after this initial implementation.

Methods and findings

A data set with the 2015 to 2017 nutritional information was developed collecting the information at 2 time periods: preimplementation (T0: January–February 2015 or 2016; n = 4,055) and postimplementation (T1: January–February 2017; n = 3,025). Quartiles of energy and nutrients of concern (total sugars, saturated fats, and sodium, per 100 g/100 mL) and the proportion of products with energy and nutrients exceeding the cutoffs of the law (i.e., products “high in”) were compared pre- and postimplementation of the law in cross-sectional samples of products with sales >1% of their specific food or beverage groups, according to the Euromonitor International Database; a longitudinal subsample (i.e., products collected in both the pre- and postimplementation periods, n = 1,915) was also analyzed. Chi-squared, McNemar tests, and quantile regressions (simple and multilevel) were used for comparing T0 and T1. Cross-sectional analysis showed a significant decrease (T0 versus T1) in the proportion of product with any “high in” (from 51% [95% confidence interval (CI) 49–52] to 44% [95% CI 42–45]), mostly in food and beverage groups in which regulatory cutoffs were below the 75th percentile of the nutrient or energy distribution. Most frequent reductions were in the proportion of “high in” sugars products (in beverages, milks and milk-based drinks, breakfast cereals, sweet baked products, and sweet and savory spreads; from 80% [95% CI 73–86] to 60% [95% CI 51–69]) and in “high in sodium” products (in savory spreads, cheeses, ready-to-eat meals, soups, and sausages; from 74% [95% CI 69–78] to 27% [95% CI 20–35]). Conversely, the proportion of products “high in” saturated fats only decreased in savory spreads (p < 0.01), and the proportion of “high in” energy products significantly decreased among breakfast cereals and savory spreads (both p < 0.01). Quantile analyses showed that most of the changes took place close to the cutoff values, with only few exceptions of overall left shifts in distribution. Longitudinal analyses showed similar results. However, it is important to note that the nonexperimental nature of this study does not allow to imply causality of these findings.


Our results show that, after initial implementation of the Chilean Law of Food Labelling and Advertising, there was a significant decrease in the amount of sugars and sodium in several groups of packaged foods and beverages. Further studies should clarify how food reformulation will impact dietary quality of the population.

Klíčová slova:

Beverages – Diet – Distribution curves – Fats – Food – Chile (country) – Milk – Nutrients


1. Vandevijvere S, Jaacks LM, Monteiro CA, Moubarac JC, Girling-Butcher M, Lee AC, et al. Global trends in ultraprocessed food and drink product sales and their association with adult body mass index trajectories. Obes Rev. 2019: 10–9. doi: 10.1111/obr.12860 31099480.

2. Popkin B, Reardon T. Obesity and the food system transformation in Latin America. Obes Rev. 2018;19(8):1028–64. doi: 10.1111/obr.12694 29691969; PubMed Central PMCID: PMC6103889.

3. GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;393(10184):1958–72. doi: 10.1016/S0140-6736(19)30041-8 30954305.

4. OECD. The heavy burden of obesity: the economics of prevention. Paris, France: OECD Health Policy Studies, 2019.

5. World Cancer Research Fund International. Improve nutritional quality of the whole food supply: World Cancer Research Fund International; 2018. Available from: [cited 2019 October 1].

6. Mantilla Herrera AM, Crino M, Erskine HE, Sacks G, Ananthapavan J, Mhurchu CN, et al. Cost-effectiveness of product reformulation in response to the Health Star Rating Food Labelling System in Australia. Nutrients. 2018;10(5):1–16. doi: 10.3390/nu10050614 29757979; PubMed Central PMCID: PMC5986494.

7. Federeci C, Detzel P, Petracca F, Dainelli L, Fattore G. The impact of food reformulation on nutrient intakes and health, a systematic review of modelling studies. BMC Nutrition. 2019;5(1):1–21. doi: 10.1186/s40795-018-0263-6 32153917

8. Scrinis G, Monteiro CA. Ultra-processed foods and the limits of product reformulation. Public Health Nutr. 2018;21(1):247–52. doi: 10.1017/S1368980017001392 28703086.

9. Nilson EAF, Spaniol AM, Goncalves VSS, Moura I, Silva SA, L'Abbe M, et al. Sodium reduction in processed foods in Brazil: analysis of food categories and voluntary targets from 2011 to 2017. Nutrients. 2017;9(7):1–12. doi: 10.3390/nu9070742 28704932; PubMed Central PMCID: PMC5537856.

10. Health Canada. Sodium reduction in processed foods in Canada: an evaluation of progress toward voluntary targets from 2012 to 2016. Health Canada, 2018-01-15.

11. Kloss L, Meyer J, Graeve L, Vatter W. Sodium intake and its reduction by food reformulation in the European Union—A review. NFS Journal. 2015;1:9–19. doi: 10.1016/j.nfs.2015.03.001

12. Curtis CJ, Clapp J, Niederman SA, Ng SW, Angell SY. US food industry progress during the National Salt Reduction Initiative: 2009–2014. Am J Public Health. 2016;106(10):1815–9. doi: 10.2105/AJPH.2016.303397 27552265; PubMed Central PMCID: PMC5024394.

13. Hyseni L, Bromley H, Kypridemos C, O’Flaherty M, Lloyd-Williams F, Guzman-Castillo M, et al. Systematic review of dietary trans-fat reduction interventions. Bull World Health Organ. 2017;95(12):821–30G. doi: 10.2471/BLT.16.189795 29200523.

14. Knai C, James L, Petticrew M, Eastmure E, Durand MA, Mays N. An evaluation of a public-private partnership to reduce artificial trans fatty acids in England, 2011–16. Eur J Public Health. 2017;27(4):605–8. doi: 10.1093/eurpub/ckx002 28339665.

15. Restrepo BJ, Rieger M. Denmark's policy on artificial trans fat and cardiovascular disease. Am J Prev Med. 2016;50(1):69–76. doi: 10.1016/j.amepre.2015.06.018 26319518.

16. Allemandi L, Tiscornia MV, Guarnieri L, Castronuovo L, Martins E. Monitoring sodium content in processed foods in Argentina 2017–2018: Compliance with national legislation and regional targets. Nutrients. 2019;11(7):1–12. doi: 10.3390/nu11071474 31261665.

17. Sacks G, Rayner M, Swinburn B. Impact of front-of-pack 'traffic-light' nutrition labelling on consumer food purchases in the UK. Health Promot Int. 2009;24(4):344–52. doi: 10.1093/heapro/dap032 19815614.

18. Mhurchu CN, Eyles H, Choi YH. Effects of a voluntary Front-of-Pack nutrition labelling system on packaged food reformulation: the Health Star Rating System in New Zealand. Nutrients. 2017;9(8):1–16. doi: 10.3390/nu9080918 28829380; PubMed Central PMCID: PMC5579711.

19. Morrison H, Meloncelli N, Pelly FE. Nutritional quality and reformulation of a selection of children's packaged foods available in Australian supermarkets: Has the Health Star Rating had an impact? Nutr Diet. 2018;76(3):296–304. doi: 10.1111/1747-0080.12486 30426624.

20. Vandevijvere S, Vanderlee L. Effect of formulation, labelling, and taxation policies on the nutritional quality of the food supply. Curr Nutr Rep. 2019;8(3):240–9. doi: 10.1007/s13668-019-00289-x 31321705.

21. World Cancer Research Fund. Nutrition label standards and regulations on the use of claims and implied claims on food London, UK: World Cancer Research Fund; 2019. Available from: [cited 2019 October 1].

22. Briggs ADM, Mytton OT, Kehlbacher A, Tiffin R, Elhussein A, Rayner M, et al. Health impact assessment of the UK soft drinks industry levy: a comparative risk assessment modelling study. Lancet Public Health. 2017;2(1):e15–e22. doi: 10.1016/S2468-2667(16)30037-8 28804786; PubMed Central PMCID: PMC5543265.

23. NYC Health. National Salt Reduction Initiative. Sodium reformulation in top U.S. chain restaurant foods: 2009–2014. New York: 2016.

24. Corvalan C, Reyes M, Garmendia ML, Uauy R. Structural responses to the obesity and non-communicable diseases epidemic: Update on the Chilean law of food labelling and advertising. Obes Rev. 2019;20(3):367–74. doi: 10.1111/obr.12802 30549191.

25. Euromonitor International. Euromonitor International Database. Available from: [cited 2019 November 9].

26. Swinburn B, Sacks G, Vandevijvere S, Kumanyika S, Lobstein T, Neal B, et al. INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support): overview and key principles. Obes Rev. 2013;14 Suppl 1:1–12. doi: 10.1111/obr.12087 24074206.

27. Dunford E, Webster J, Metzler AB, Czernichow S, Ni Mhurchu C, Wolmarans P, et al. International collaborative project to compare and monitor the nutritional composition of processed foods. Eur J Prev Cardiol. 2012;19(6):1326–32. doi: 10.1177/1741826711425777 21971487.

28. Kanter R, Reyes M, Corvalan C, Vandevijvere S, Swinburn B. Anticipatory effects of the implementation of the Chilean Law of Food Labeling and Advertising on food and beverage product reformulation. Obes Rev. 2019;20 Suppl 2:129–40. doi: 10.1111/obr.12870 31245920

29. Otten JJ, Hekler EB, Krukowski RA, Buman MP, Saelens BE, Gardner CD, et al. Food marketing to children through toys: response of restaurants to the first U.S. toy ordinance. Am J Prev Med. 2012;42(1):56–60. doi: 10.1016/j.amepre.2011.08.020 22176847.

30. Ning SX, Mainvil LA, Thomson RK, McLean RM. Dietary sodium reduction in New Zealand: influence of the Tick label. Asia Pac J Clin Nutr. 2017;26(6):1133–8. doi: 10.6133/apjcn.032017.06 28917241.

31. Savio S, Mehta K, Udell T, Coveney J. A survey of the reformulation of Australian child-oriented food products. BMC Public Health. 2013;13:1–13. doi: 10.1186/1471-2458-13-1 24025190; PubMed Central PMCID: PMC3847458.

32. Thomson RK, McLean RM, Ning SX, Mainvil LA. Tick front-of-pack label has a positive nutritional impact on foods sold in New Zealand. Public Health Nutr. 2016;19(16):2949–58. doi: 10.1017/S1368980016001208 27356176.

33. Vyth EL, Steenhuis IH, Roodenburg AJ, Brug J, Seidell JC. Front-of-pack nutrition label stimulates healthier product development: a quantitative analysis. Int J Behav Nutr Phys Act. 2010;7:1–7. doi: 10.1186/1479-5868-7-1 20825645; PubMed Central PMCID: PMC2945986.

34. World Health Organization (WHO). Guiding principles and framework manual for front-of-pack labeling for promoting healthy diet. Geneva: World Health Organization; 2019.

35. Ares G, Bove I, Díaz R, Moratorio X, Benia W, Gomes F. [Food industry arguments against front-of-package nutrition labels in UruguayArgumentos da indústria alimentícia contra a rotulagem frontal de advertência nutricional no Uruguai]. Rev Panam Salud Publica. 2020;44:e20–e28. doi: 10.26633/RPSP.2020.20 32256545; PubMed Central PMCID: PMC7115343.

36. de Oliveira Otto MC, Mozaffarian D, Kromhout D, Bertoni AG, Sibley CT, Jacobs DR, et al. Dietary intake of saturated fat by food source and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr. 2012;96(2):397–404. doi: 10.3945/ajcn.112.037770 22760560; PubMed Central PMCID: PMC3396447.

37. Dunford EK, Ni Mhurchu C, Huang L, Vandevijvere S, Swinburn B, Pravst I, et al. A comparison of the healthiness of packaged foods and beverages from 12 countries using the Health Star Rating nutrient profiling system, 2013–2018. Obes Rev. 2019;20 Suppl 2:107–15. doi: 10.1111/obr.12879 31328385.

38. Cediel G, Reyes M, da Costa Louzada ML, Martinez Steele E, Monteiro CA, Corvalan C, et al. Ultraprocessed foods and added sugars in the Chilean diet (2010). Public Health Nutr. 2018;21(1):125–33. doi: 10.1017/S1368980017001161 28625223.

39. Agostini C, Corvalán C, Cuadrado C, Martínez C, Paraje G. Evaluación y Aplicación de Impuestos a los Alimentos con Nutrientes Dañinos para la Salud en Chile. Final Report from the Expert Committee. Santiago de Chile: Ministry of Finance, Ministry of Health and Inter-American Development Bank (IADB), 2018.

40. Rebolledo N, Reyes M, Corvalán C, Popkin BM, Smith Taillie L. Dietary intake by food source and eating location in low- and middle-income Chilean preschool children and adolescents from Southeast Santiago. Nutrients. 2019;11(7):1–18. doi: 10.3390/nu11071695 31340559.

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2020 Číslo 7
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