Product reformulation in non-alcoholic beverages and foods after the implementation of front-of-pack warning labels in Mexico.

IF 15.8 1区 医学 Q1 Medicine
PLoS Medicine Pub Date : 2025-03-18 eCollection Date: 2025-03-01 DOI:10.1371/journal.pmed.1004533
Juan Carlos Salgado, Lilia S Pedraza, Alejandra Contreras-Manzano, Tania C Aburto, Lizbeth Tolentino-Mayo, Simon Barquera
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引用次数: 0

Abstract

Background: In late March 2020, the Mexican government announced an updated norm to include front-of-pack warning labels for packaged foods and non-alcoholic beverages. Warning labels came into effect in October 2020. To avoid displaying warning labels, producers can reformulate their products by reducing the content of calories or critical nutrients targeted by the policy (added sugars, saturated fat, and sodium) or removing non-caloric sweeteners or added caffeine. The objective of this study is to assess changes in the percentage of products above warning-label cutoffs for calories and critical nutrients and changes in the content of calories and critical nutrients associated with warning labels in Mexico.

Methods and findings: We used nutritional panel data collected by the Mexican National Institute of Public Health from ≈1,000 top-purchased products, which represented ≥60% of the market share for each of the included food groups according to household purchases in the Nielsen Consumer Panel commercial dataset for Mexico in 2016. Nutritional panel data is available for three periods: 2016-2017, T0 (pre-policy); Jul-Sep 2020, T1 (post-warning-label announcement); and Feb-Apr 2021, T2 (post-warning-label implementation). We assessed changes in T1 versus T0 (potential anticipatory reformulation before the warning-label implementation) and T2 versus T0 (reformulation after the warning-label implementation) by food group using generalized estimating equations for the percentage of products above warning-label cutoffs or containing non-caloric sweeteners or added caffeine, and fixed-effects linear models and quantile regressions for the content of calories and critical nutrients. Included food groups were cereal-based desserts, bread and other cereals, salty snacks, sweetened beverages, solid dairy, liquid dairy, instant food, and candies. At T0, the food group level with the lowest percentage of products with at least one calorie/nutrient content above warning-label cutoffs was instant food (77.8%); at T2, this fell to 52.6%. Based on our statistical models, we found that all food groups showed reductions in at least one type of warning label. The most common reductions in the percentage of products exceeding warning-label cutoffs were for sodium (up to -63.1 percentage points for bread and other cereals; 95% CI: -77.5, -48.6; p-value < 0.001), saturated fat (up to -26.3 percentage points for salty snacks; 95% CI: -35.8, -16.8; p-value < 0.001), and products containing non-caloric sweeteners (up to -29.0 percentage points for solid dairy; 95% CI: -40.7, -17.2; p-value < 0.001). The reductions in products above warning-label cutoffs were coupled with reductions in products' content of calories and critical nutrients. According to quantile regressions, these reductions mostly occurred at the 50th-75th percentiles. Product reformulation mainly occurred in T2.

Conclusion: Our findings show product reformulation due to reductions in critical nutrients/calories after the warning-label policy implementation, which entails improving the nutritional profile of the packaged food and beverage supply in Mexico.

在墨西哥实施包装正面警告标签后,非酒精饮料和食品中的产品重新配方。
背景:2020年3月下旬,墨西哥政府宣布了一项更新的规范,将包装食品和非酒精饮料的包装正面警告标签纳入其中。警告标签将于2020年10月生效。为了避免显示警告标签,生产商可以通过减少卡路里或政策所针对的关键营养素(添加糖、饱和脂肪和钠)的含量或去除无热量甜味剂或添加咖啡因来重新配制产品。本研究的目的是评估墨西哥产品中卡路里和关键营养素含量高于警告标签临界值的百分比的变化,以及与警告标签相关的卡路里和关键营养素含量的变化。方法和研究结果:我们使用了墨西哥国家公共卫生研究所收集的约1000种顶级购买产品的营养小组数据,根据2016年墨西哥尼尔森消费者小组商业数据集中的家庭购买情况,这些产品代表了每个纳入食品组的市场份额≥60%。营养面板数据可用于三个时期:2016-2017,T0(政策前);2020年7月- 9月,T1(警告标签后公告);2021年2月至4月,T2(后警告标签实施)。我们评估了食品组T1与T0(实施警告标签前的潜在预期重新配方)和T2与T0(实施警告标签后的重新配方)的变化,使用了高于警告标签临界值或含有无热量甜味剂或添加咖啡因的产品百分比的广义估计方程,以及固定效应线性模型和卡路里和关键营养素含量的分位数回归。包括以谷物为基础的甜点、面包和其他谷物、咸零食、加糖饮料、固体乳制品、液体乳制品、速食食品和糖果。在T0时,至少有一种卡路里/营养素含量高于警告标签临界值的食品比例最低的食品组是速食食品(77.8%);T2时,这一比例降至52.6%。根据我们的统计模型,我们发现所有的食物组都至少减少了一种警告标签。在超过警告标签上限的产品百分比中,最常见的是钠(面包和其他谷物高达-63.1个百分点;95% ci: -77.5, -48.6;p值结论:我们的研究结果表明,在实施警告标签政策后,由于关键营养素/卡路里的减少,产品重新配方,这需要改善墨西哥包装食品和饮料供应的营养状况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
PLoS Medicine
PLoS Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
17.60
自引率
0.60%
发文量
227
审稿时长
4-8 weeks
期刊介绍: PLOS Medicine is a prominent platform for discussing and researching global health challenges. The journal covers a wide range of topics, including biomedical, environmental, social, and political factors affecting health. It prioritizes articles that contribute to clinical practice, health policy, or a better understanding of pathophysiology, ultimately aiming to improve health outcomes across different settings. The journal is unwavering in its commitment to uphold the highest ethical standards in medical publishing. This includes actively managing and disclosing any conflicts of interest related to reporting, reviewing, and publishing. PLOS Medicine promotes transparency in the entire review and publication process. The journal also encourages data sharing and encourages the reuse of published work. Additionally, authors retain copyright for their work, and the publication is made accessible through Open Access with no restrictions on availability and dissemination. PLOS Medicine takes measures to avoid conflicts of interest associated with advertising drugs and medical devices or engaging in the exclusive sale of reprints.
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