"Responses to the Chilean law of food labeling and advertising: exploring knowledge, perceptions and behaviors of mothers of young children"

Teresa Correa, Camila Fierro, Marcela Reyes, Francesca R Dillman Carpentier, Lindsey Smith Taillie, Camila Corvalan, Teresa Correa, Camila Fierro, Marcela Reyes, Francesca R Dillman Carpentier, Lindsey Smith Taillie, Camila Corvalan

Abstract

Background: In line with calls for action from international health organizations, Chile implemented in June 2016 a set of regulations to tackle the obesity epidemic. The new regulation includes the mandatory use of front-of-package warning labels on packaged foods/beverages high in energy, sugars, saturated fats and sodium. Additionally, such foods cannot be sold nor offered in daycares/schools and cannot be promoted to children under 14yo. The law is targeted to children; thus, this study examined mothers' understanding, perceptions, and behaviors associated with the regulation one year after its implementation, using a qualitative approach.

Methods: Nine focus groups of mothers (7-10 people each) of children (2-14yo) were conducted in July 2017 in Santiago-Chile. They were stratified by socioeconomic status (SES) and children's age. Macrocodes were developed by three researchers, combining an iterative process of deductive and inductive thematic analyses. Quotations representing each category were selected.

Results: Mothers understood the new regulation as a policy to fight child obesity and were aware that products with more labels were less healthy than products with fewer labels. Attention and use of labels in the buying decision-making process ranged from participants who did not pay attention to others who relied on them as a quick shortcut (mostly from middle and upper-SES); many mothers indicated changing their purchase habits only when buying new products. Mothers declared that young children accepted school environment changes while teens/preteens resisted them more. Many mothers agreed that schools have become key promoters of food behavioral change. Mothers were less aware about the food marketing regulations. Mothers declared that they perceived that the regulation was changing the perceptions, attitudes and behaviors toward healthier eating patterns.

Conclusion: After the first year of implementation, the regulation was well known by mothers of diverse SES and different children ages. The degree of use of warning labels was heterogeneous among participants, but most of them agreed that their children, particularly the youngest have positive attitudes toward the regulation and have become promoters of change in their families. Many mothers also expressed that they perceived an important shift toward healthier eating, which may lead to a change in eating social norms. This information contributes to better understand how regulatory actions may influence people's consumer behaviors.

Keywords: Behaviors associated with the Regulation; Chile; Focus Groups; Food Labeling; Food Marketing; Food Regulation; Front-of-package (FOP) labeling; Perceptions of the Regulation; Understanding of the Regulation.

Conflict of interest statement

Ethics approval and consent to participate

The Institutional Review Boards from the Institute of Nutrition and Food Technology (INTA), University of Chile, and the School of Communication, Diego Portales University approved all phases of the study. Informed consent was signed by participants. A small gift was given to participants of the group meetings as compensation.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Pan American Health Organization (PAHO). Recommendations from a Pan American health organization expert consultation on the Marketing of Food and non-Alcoholic Beverages to children in the Americas. Washington, D.C.: PAHO; 2011.
    1. World Health Organization (WHO). Tackling food marketing to children in a digital world: trans-disciplinary perspectives. Children’s rights, evidence of impact, methodological challenges, regulatory options and policy implications for the WHO European Region. Copenhagen: WHO; 2016.
    1. United Nations International Children’s Emergency Fund . Review of current labelling regulations and practices for food and beverage targeting children and adolescents in Latin America countries (Mexico, Chile, Costa Rica and Argentina) and recommendations for facilitating consumer information. 2016.
    1. Hawkes C. Regulating and litigating in the public interest: regulating food marketing to young people worldwide: trends and policy drivers. Am J Public Health. 2007;97(11):1962–1973. doi: 10.2105/AJPH.2006.101162.
    1. Batis C, Rivera J, Popkin B, Taillie L. First-year evaluation of Mexico’s tax on nonessential energy-dense foods: an observational study. PLoS Med. 2016;13(7):e1002057. doi: 10.1371/journal.pmed.1002057.
    1. Downs SM, Farmer A, Quintanilha M, Berry TR, Mager DR, Willows ND, et al. Alberta nutrition guidelines for children and youth: awareness and use in schools. Can J Diet Pract Res. 2011;72(3):137–140. doi: 10.3148/72.3.2011.137.
    1. Junta Nacional de Auxilio Escolar y Becas. Informe Mapa Nutricional 2016. Santiago de Chile: Junta Nacional de Auxilio Escolar y Becas; 2016. Available from: ​.
    1. Ministerio de Salud. Encuesta Nacional de Salud 2016-2017: Primeros resultados​. Santiago de Chile: Ministerio de Salud; 2017. Available from: .
    1. Corvalan C, Reyes M, Garmendia ML, Uauy R. Structural responses to the obesity and non-communicable diseases epidemic: the Chilean law of food labeling and advertising. Obes Rev. 2013;14(Suppl 2):79–87. doi: 10.1111/obr.12099.
    1. Corvalán 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. 2018;​20(3):367-74.
    1. Birch LL, Davison KK. Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatr Clin N Am. 2001;48(4):893–907. doi: 10.1016/S0031-3955(05)70347-3.
    1. Hawkes C, Smith TG, Jewell J, Wardle J, Hammond RA, Friel S, et al. Smart food policies for obesity prevention. Lancet. 2015;385(9985):2410–21. doi: 10.1016/S0140-6736(14)61745-1.
    1. Bryman A. Social research methods. Melbourne: Oxford University press; 2012. p. 766.
    1. Kitzinger J. The methodology of focus groups: the importance of interaction between research participants - Kitzinger - 1994 - sociology of Health & Illness - Wiley online library. Sociol Health Illn. 1994;16:103–121. doi: 10.1111/1467-9566.ep11347023.
    1. Rachmi CN, Hunter CL, Li M, Baur LA. Perceptions of overweight by primary carers (mothers/grandmothers) of under five and elementary school-aged children in Bandung, Indonesia: a qualitative study. Int J Behav Nutr Phys Act. 2017;14(1):101. doi: 10.1186/s12966-017-0556-1.
    1. Ministerio de Desarrollo Social. Pobreza y distribución del ingreso en la Región Metropolitana de Santiago: resultados encuesta CASEN 2015. Santiago de Chile: Ministerio de Desarrollo Social; 2016.
    1. Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. Int J Qual Methods. 2006;5(1).
    1. Crabtree BF, Miller WL. Doing Qualitative Research: SAGE Publications; 1999. p. 424.
    1. Rice PL, Ezzy D. Qualitative research methods - a health focus. Melbourne: Oxford University Press; 1999. p. 295.
    1. Sacks G, Veerman JL, Moodie M, Swinburn B. 'Traffic-light' nutrition labelling and 'junk-food' tax: a modelled comparison of cost-effectiveness for obesity prevention. Int J Obes. 2011;35(7):1001–1009. doi: 10.1038/ijo.2010.228.
    1. Magnusson R. Obesity prevention and personal responsibility: the case of front-of-pack food labelling in Australia. BMC Public Health. 2010;10:662. doi: 10.1186/1471-2458-10-662.
    1. van Herpen E, Trijp HC. Front-of-pack nutrition labels. Their effect on attention and choices when consumers have varying goals and time constraints. Appetite. 2011;57(1):148–160. doi: 10.1016/j.appet.2011.04.011.
    1. Antúnez L, Giménez A, Maiche A, Ares G. Influence of interpretation aids on attentional capture, visual processing, and understanding of front-of-package nutrition labels. J Nutr Educ Behav. 2015;47(4):292–299. doi: 10.1016/j.jneb.2015.02.010.
    1. Arrúa A, Machín L, Curutchet MR, Martínez J, Antúnez L, Alcaire F, et al. Warnings as a directive front-of-pack nutrition labelling scheme: comparison with the guideline daily amount and traffic-light systems. Public Health Nutr. 2017;20(13):2308–2317. doi: 10.1017/S1368980017000866.
    1. Ares G, Gimenez A, Bruzzone F, Antunez L, Sapolinski A, Vidal L, et al. Attentional capture and understanding of nutrition labelling: a study based on response times. Int J Food Sci Nutr. 2012;63(6):679–688. doi: 10.3109/09637486.2011.652598.
    1. Bialkova S, Grunert K, Van Trijp H. Standing out in the crowd: the effect of information clutter on consumer attention for front-of-pack nutrition labels. Science Direct. 2013;41:65–74.
    1. Gruner K, Wills J. A Review of European Research on Consumer Response to Nutrition Information on Food Labels | Sci-napse | Academic search engine for paper. J Public Health. 2007;15:385–399. doi: 10.1007/s10389-007-0101-9.
    1. Veugelers PJ, Fitzgerald AL. Effectiveness of school programs in preventing childhood obesity: a multilevel comparison. Am J Public Health. 2005;95(3):432–435. doi: 10.2105/AJPH.2004.045898.
    1. Wechsler H, Devereaux RS, Davis M, Collins J. Using the school environment to promote physical activity and healthy eating. Prev Med. 2000;31(2):S121–SS37. doi: 10.1006/pmed.2000.0649.
    1. Briefel RR, Crepinsek MK, Cabili C, Wilson A, Gleason PM. School food environments and practices affect dietary behaviors of US public school children. J Am Diet Assoc. 2009;109(2 Suppl):S91–107. doi: 10.1016/j.jada.2008.10.059.
    1. Osei-Assibey G, Dick S, Macdiarmid J, Semple S, Reilly JJ, Ellaway A, et al. The influence of the food environment on overweight and obesity in young children: a systematic review. BMJ Open. 2012;2(6).
    1. Davis B, Carpenter C. Proximity of fast-food restaurants to schools and adolescent obesity. Am J Public Health. 2009;99(3):505–510. doi: 10.2105/AJPH.2008.137638.
    1. French SA, Story M, Fulkerson JA, Gerlach AF. Food environment in secondary schools: a la carte, vending machines, and food policies and practices. Am J Public Health. 2003;93(7):1161–7. doi: 10.2105/AJPH.93.7.1161.
    1. Crawford PB, Gosliner W, Kayman H. The ethical basis for promoting nutritional health in public schools in the United States. Prev Chronic Dis. 2011;8(5):A98.
    1. Kinzig AP, Ehrlich PR, Alston LJ, Arrow K, Barrett S, Buchman TG, et al. Social norms and global environmental challenges: the complex interaction of behaviors, values, and policy. Bioscience. 2013;63(3):164–175. doi: 10.1525/bio.2013.63.3.5.
    1. Story M, Kaphingst KM, French S. The role of schools in obesity prevention. Futur Child. 2006;16(1):109–142. doi: 10.1353/foc.2006.0007.
    1. Petty RE, Cacioppo JT, Schumann D. Central and Peripheral Routes to Advertising Effectiveness: The Moderating Role of Involvement. J Consum Res. 2018;10(2):135–146. doi: 10.1086/208954.
    1. Nisbett RE, Wilson TD. The halo effect: evidence for unconscious alteration of judgments. J Pers Soc Psychol. 1977;35(4):250–256. doi: 10.1037/0022-3514.35.4.250.
    1. Ministerio de Desarrollo Social. Panorama CASEN 2015. Hogares y bienestar: Análisis de cambios en la estructura de los hogares 1990-2015. Santiago de Chile: Ministerio de Desarrollo Social; 2017.

Source: PubMed

3
Subskrybuj