Worldwide obesity has nearly tripled since 1975. In 2016, more than 1.9 billion adults were overweight. Of these over 650 million were obese. Obesity has reached epidemic proportions globally, with over 2.8 million people dying each year as a result of being overweight or obese. Alongside this human health crisis we are confronting an ecological crisis – food high in saturated fats, sugars and salts, high in calories, low in nutrients contribute to climate change, biodiversity loss and environmental contamination. Chile, a country plagued by high levels of obesity has some of the world’s toughest controls which has resulted in a 23% drop in sugary drink sales over just 2 years. Governments around the world need to address the twin human and planetary health crisis. They should be taking a leaf out of Chile’s obesity playbook through marketing restrictions, labelling and taxation.
What did Chile do to tackle obesity?
In 2016 Chile implemented a set of regulations to tackle the obesity epidemic, including associated non communicable diseases and cancer, with a particular focus on children. Their legislation focussed on three key goals:
i) Reducing children’s exposure to marketing (through food packaging, TV, cinemas etc)
ii) The prohibition on selling and offering unhealthy foods at schools and nurseries.
iii) Reformulation of processed foods – Not a primary focus of the law but an ambition through hope this is achieved through a response to regulations.
The linchpin of the initiative was a new labelling system that requires packaged food companies to prominently display black warning logos in the shape of a stop sign on items high in sugar, salt, calories or saturated fat. A set of marketing restrictions implemented were very comprehensive, addressing both the exposure and power of marketing strategies. Restrictions in advertising included TV, cinema, internet, magazines, billboards, flyers, shop window and on food packages themselves. In May 2018, a new regulation launched that extended marketing restrictions of regulated foods in cinema and TV to a 6am to 10pm time frame, expanding the scope of the original law.
What is also striking is the novel approach to addressing some of the social determinants of health. To protect children, the regulation included restrictions to ensure healthier school environments and included the prohibition to sell highly processed foods for free at cafeterias, kiosks, vending machines, or any other retail sale inside schools or nursery schools. The law included the School Feeding Programme that provides free breakfast, snacks, and lunch to more than 50% school‐age children (belonging to the most disadvantaged families) from public and private subsidized schools.
Reflecting on the implementation of the law Senator Guido Girardi, who was an instrumental champion with the Chilean government for the project said “People have a right to know what these food companies are putting in this trash, and with this legislation, I think Chile has made a huge contribution to humanity.” The strong partnership and collaboration between government and academia, with a focus on building an evidence base, ensured a strong case for action, to address some of the key social and environmental determinants of health, were the basis of these new policies.
The Impact of Chile’s Policies
In February this year Researchers from the University of North Carolina at Chapel Hill Gillings School of Global Public Health, published results of an evaluation on Chile’s policies and published the results in the journal Plos Medicine. They have found purchases of sugary drinks dropped by 23.7% during the first phase of the reforms. The largest changes were in the amount of sweetened fruit drinks and sweetened dairy drinks purchased. Whilst its still too early to assess how these policies will impact on Chile’s obesity crisis these early results are really impressive and demonstrate that government leadership is going if we are going to stem the obesity crisis in the future.
Lessons from Chile’s playbook
Governments around the world need to follow the lead of Chile by implementing laws which protect children from marketing strategies which target them and bring policies that sensitise children about unhealthy junk foods and sweetened beverages. There are signs that other governments are looking closely at how Chile is tackling its obesity crisis. Its already been copied by Israel. Peru and Uruguay and I hope that others will quickly follow. Just as free plastic toys are becoming unacceptable as part of kids meals so should characters like Tony the Tiger, Coco the Monkey and a host of other cartoon mascots that front children’s high sugar breakfast cereals.
Please visit my blog on Sustainable Nutrition which explains how and why i believe governments should be tackling the systemic barriers to human and planetary health.