Chile's food warning labels and ad bans cut child obesity risk, analysis suggests
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Chile's complementary set of policies targeting food products high in fat, salt and sugar plausibly reduces the risk of school-age children being overweight or having obesity, finds a study published in The Lancet.
Chile ranks among the countries with the highest rates of childhood overweight and obesity globally. To combat this issue, in 2016, Chile implemented one of the world's most comprehensive and ambitious food policies, the Food Labeling and Advertising Law (FLAL).
The FLAL targets foods and drinks high in sugars, saturated fats, salt or calories through three core measures: mandatory front-of-package warning labels in the form of black octagons, restrictions on the sale of such products in schools, and limits on food marketing directed at children.
Prof. Guillermo Paraje, professor of economics at Universidad Adolfo Ibáñez Business School in Chile, says, "Although individual national measures like sugar taxes on soft drinks have been associated with improved health outcomes, this is the first study to plausibly demonstrate that a package of policies can reduce early childhood overweight/obesity risk at the national level.
"These results offer strong evidence for policymakers around the world. They support mandatory front-of-pack nutrition warning labels, restrictions on unhealthy food in schools, and marketing bans as effective, practical ways to tackle the childhood obesity epidemic."
National data on more than 300,000 schoolchildren ages 4 to 6 in Chile were used to compare children's weight in the years before the introduction of FLAL with the weight and size of children in the same school grades after the first phase of the law took effect in 2016.
The study found that children who had been at school for 18 months after the introduction of FLAL Phase 1 were less likely to be overweight or have obesity than those in the same grades before FLAL. Girls had a 2.9% lower risk of overweight or obesity (a reduction of 1.4 percentage points from a pre-FLAL rate of 47.7%), while boys had a 2.4% lower risk (a reduction of 1.2 percentage points from a pre-FLAL rate of 52%).
The study also found a plausible causal impact in the cohort of schoolchildren ages 4 to 6 after only six months of FLAL Phase 1: girls had a 1.9% lower risk of overweight or obesity (a reduction of 0.9 percentage points from a pre-FLAL prevalence of 47.4%), and boys had a 2.2% lower risk (a reduction of 1.2 percentage points from a pre-FLAL prevalence of 52%).
Phases 2 and 3 of FLAL set stricter limits on sugars, saturated fats, salt or calories. These phases were introduced in 2018 and 2019, so they did not affect the study's results.
Dr. Nieves Valdes, associate professor of economics at Universidad Adolfo Ibáñez Business School in Chile, says, "Although the reduction in obesity and overweight risk among young schoolchildren may seem modest, it is likely that the further tightening of the law in later years increased the impact, especially given evidence that there was a greater drop in sales of labeled food products during Phase 2 of the FLAL compared with Phase 1.
"Additionally, even a small weight reduction for children who have overweight or obesity is likely to bring meaningful long-term health benefits, given the strong links between childhood obesity and later risk of obesity, diabetes, hypertension and cardiovascular disease, as well as evidence that early prevention can substantially lower these risks."
The researchers note some limitations of their study, including that the plausible causality of the relationship relies on the assumption that, if the FLAL hadn't been introduced, the two cohorts of schoolchildren would have followed the same nutrition trends.
That cannot be tested, although support for the assumption was provided through pre-policy trends. Additionally, the children's weight was collected by school staff who, although trained for this task, may not achieve the same precision typically found in primary health care settings.
Writing in a linked Comment, Prof. Simone Pettigrew and Dr. Daisy Coyle of The George Institute for Global Health in Australia, who were not involved in the study, say, "In a policy environment where industry opposition constitutes a formidable obstacle to the implementation of health-promoting policies, high-quality, real-world evidence is critical. … the research results strengthen the case for governments to move beyond incremental, single-policy approaches and to instead implement comprehensive, integrated strategies to improve food environments.
"In particular, the results highlight the potential for policy suites including mandatory warning labels and marketing restrictions on unhealthy foods and school food minimum standards to produce meaningful outcomes."
Publication details
The impact of Chile's multipronged food labelling and advertising law on early childhood excess weight: a cohort difference-in-differences study, The Lancet (2026). DOI: 10.1016/S0140-6736(26)00651-3
Journal information: The Lancet
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