Predicting obesity reduction after implementing warning labels in Mexico: A modeling study


Autoři: Ana Basto-Abreu aff001;  Rossana Torres-Alvarez aff001;  Francisco Reyes-Sánchez aff001;  Romina González-Morales aff001;  Francisco Canto-Osorio aff001;  M. Arantxa Colchero aff002;  Simón Barquera aff003;  Juan A. Rivera aff004;  Tonatiuh Barrientos-Gutierrez aff001
Působiště autorů: Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico aff001;  Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico aff002;  Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico aff003;  National Institute of Public Health, Cuernavaca, Mexico aff004
Vyšlo v časopise: Predicting obesity reduction after implementing warning labels in Mexico: A modeling study. PLoS Med 17(7): e32767. doi:10.1371/journal.pmed.1003221
Kategorie: Research Article
doi: 10.1371/journal.pmed.1003221

Souhrn

Background

In October 2019, Mexico approved a law to establish that nonalcoholic beverages and packaged foods that exceed a threshold for added calories, sugars, fats, trans fat, or sodium should have an “excess of” warning label. We aimed to estimate the expected reduction in the obesity prevalence and obesity costs in Mexico by introducing warning labels, over 5 years, among adults under 60 years of age.

Methods and findings

Baseline intakes of beverages and snacks were obtained from the 2016 Mexican National Health and Nutrition Survey. The expected impact of labels on caloric intake was obtained from an experimental study, with a 10.5% caloric reduction for beverages and 3.0% caloric reduction for snacks. The caloric reduction was introduced into a dynamic model to estimate weight change. The model output was then used to estimate the expected changes in the prevalence of obesity and overweight. To predict obesity costs, we used the Health Ministry report of the impact of overweight and obesity in Mexico 1999–2023. We estimated a mean caloric reduction of 36.8 kcal/day/person (23.2 kcal/day from beverages and 13.6 kcal/day from snacks). Five years after implementation, this caloric reduction could reduce 1.68 kg and 4.98 percentage points (pp) in obesity (14.7%, with respect to baseline), which translates into a reduction of 1.3 million cases of obesity and a reduction of US$1.8 billion in direct and indirect costs. Our estimate is based on experimental evidence derived from warning labels as proposed in Canada, which include a single label and less restrictive limits to sugar, sodium, and saturated fats. Our estimates depend on various assumptions, such as the transportability of effect estimates from the experimental study to the Mexican population and that other factors that could influence weight and food and beverage consumption remain unchanged. Our results will need to be corroborated by future observational studies through the analysis of changes in sales, consumption, and body weight.

Conclusions

In this study, we estimated that warning labels may effectively reduce obesity and obesity-related costs. Mexico is following Chile, Peru, and Uruguay in implementing warning labels to processed foods, but other countries could benefit from this intervention.

Klíčová slova:

Beverages – Body mass index – Body weight – Fats – Food – Mexican people – Mexico – Obesity


Zdroje

1. Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2019;30: 67–77.e3. doi: 10.1016/j.cmet.2019.05.008 31105044

2. Pan American Health Organization. Ultra-processed food and drink products in Latin America: Trends, impact on obesity, policy implications [Internet]. Washington; 2015 [cited 2019 Oct 15]. Available from: http://iris.paho.org/xmlui/bitstream/handle/123456789/7699/9789275118641_eng.pdf

3. Basto-Abreu A, Barrientos-Gutiérrez T, Vidaña-Pérez D, Colchero MA, Hernández-F M, Hernández-Ávila M, et al. Cost-Effectiveness Of The Sugar-Sweetened Beverage Excise Tax In Mexico. Health Aff. Health Affairs; 2019;38: 1824–1831. doi: 10.1377/hlthaff.2018.05469 31682510

4. Secretaria de gobernación. MODIFICACIÓN a la Norma Oficial Mexicana NOM-051-SCFI/SSA1-2010, Especificaciones generales de etiquetado para alimentos y bebidas no alcohólicas preenvasados-Información comercial y sanitaria, publicada el 5 de abril de 2010 [Internet]. Secretaria de economia; 2020 [cited 2020 Jan 15]. Available from: https://www.dof.gob.mx/2020/SEECO/NOM_051.pdf

5. Secretaría de Economía—Gobierno de México. Fue aprobada la modificación a la NOM 051 sobre etiquetado de alimentos y bebidas [Internet]. Mexico City; 2020 [cited 2020 Jan 28]. Available from: https://www.gob.mx/se/articulos/fue-aprobada-la-modificacion-a-la-nom-051-sobre-etiquetado-de-alimentos-y-bebidas

6. Pan American Health Organization. Nutrient Profile Model [Internet]. Nutrient Profile Model. Washington, DC; 2016. doi: 10.1021/cm0344764

7. VanEpps EM, Roberto CA. The Influence of Sugar-Sweetened Beverage Warnings: A Randomized Trial of Adolescents’ Choices and Beliefs. Am J Prev Med. 2016;51: 664–672. doi: 10.1016/j.amepre.2016.07.010 27617366

8. Roberto CA, Wong D, Musicus A, Hammond D. The influence of sugar-sweetened beverage health warning labels on parents’ choices. Pediatrics. 2016;137. doi: 10.1542/peds.2015-3185 26768346

9. Donnelly GE, Zatz LY, Svirsky D, John LK. The Effect of Graphic Warnings on Sugary-Drink Purchasing. Psychol Sci. 2018;29: 1321–1333. doi: 10.1177/0956797618766361 29912624

10. Acton RB, Jones AC, Kirkpatrick SI, Roberto CA, Hammond D. Taxes and front-of-package labels improve the healthiness of beverage and snack purchases: A randomized experimental marketplace. Int J Behav Nutr Phys Act. International Journal of Behavioral Nutrition and Physical Activity; 2019;16: 1–15. doi: 10.1186/s12966-018-0763-4

11. Machín L, Curutchet MR, Giménez A, Aschemann-Witzel J, Ares G. Do nutritional warnings do their work? Results from a choice experiment involving snack products. Food Qual Prefer. 2019;77: 159–165. doi: 10.1016/j.foodqual.2019.05.012

12. Grummon AH, Taillie LS, Golden SD, Hall MG, Ranney LM, Brewer NT. Sugar-Sweetened Beverage Health Warnings and Purchases: A Randomized Controlled Trial. Am J Prev Med. Elsevier Inc.; 2019;57: 601–610. doi: 10.1016/j.amepre.2019.06.019 31586510

13. Grummon AH, Smith NR, Golden SD, Frerichs L, Taillie LS, Brewer NT. Health Warnings on Sugar-Sweetened Beverages: Simulation of Impacts on Diet and Obesity Among U.S. Adults. Am J Prev Med. Elsevier Inc.; 2019;57: 765–774. doi: 10.1016/j.amepre.2019.06.022 31630966

14. Hall KD, Sacks G, Chandramohan D, Chow CC, Wang YC, Gortmaker SL, et al. Quantification of the effect of energy imbalance on bodyweight. Lancet. 2011;378: 826–837. doi: 10.1016/S0140-6736(11)60812-X 21872751

15. Romero-Martínez M, Shamah-Levy T, Cuevas-Nasu L, Méndez Gómez-Humarán I, Gaona-Pineda EB, Gómez-Acosta LM, et al. Diseño metodológico de la Encuesta Nacional de Salud y Nutrición de Medio Camino 2016. Salud Publica Mex. 2017;59: 299. doi: 10.21149/8593 28902317

16. Consejo Nacional de Poblacion. Proyecciones de los hogares en México y las Entidades Federativas, 2016–2050 In: México en cifras [Internet]. 2014 p. 1 [cited 2020 Jan 15]. Available from: https://datos.gob.mx/busca/dataset/proyecciones-de-la-poblacion-de-mexico-y-de-las-entidades-federativas-2016-2050

17. Basto-Abreu A, Braverman-Bronstein A, Camacho-García-Formentí D, Zepeda-Tello R, Popkin BM, Rivera-Dommarco J, et al. Expected changes in obesity after reformulation to reduce added sugars in beverages: A modeling study. PLoS Med. 2018;15: e1002664. doi: 10.1371/journal.pmed.1002664 30289898

18. Barrientos-Gutierrez T, Zepeda-Tello R, Rodrigues ER, Colchero-Aragonés A, Rojas-Martínez R, Lazcano-Ponce E, et al. Expected population weight and diabetes impact of the 1-peso-per-litre tax to sugar sweetened beverages in Mexico. PLoS ONE. 2017;12: e0176336. doi: 10.1371/journal.pone.0176336 28520716

19. Taillie LS, Reyes M, Colchero MA, Popkin B, Corvalán C. An evaluation of Chile’s Law of Food Labeling and Advertising on sugar-sweetened beverage purchases from 2015 to 2017: A before-and-after study. Basu S, editor. PLoS Med. Public Library of Science; 2020;17: e1003015. doi: 10.1371/journal.pmed.1003015 32045424

20. Secretaria de la Salud. Impacto financiero del Sobrepeso y Obesidad en México 1999–2023. Nota técnica [Internet]. Ciudad de México; 2015 [cited 2019 Nov 15]. Available from: http://oment.salud.gob.mx/wp-content/uploads/2016/09/impacto_financiero_OyS_060815_oment.pdf

21. Instituto Nacional de Estadística y Geografía (INEGI). Índice Nacional de Precios al Consumidor (INPC) [Internet]. 2019 [cited 2020 Feb 4]. Available from: https://www.inegi.org.mx/temas/inpc/

22. Neumann PJ, Sanders GD, Russell LB, Siegel JE, Ganiats TG. Cost-Effectiveness in Health and Medicine. 2nd Editio. New York: Oxford University Press; 2016. doi: 10.1136/bmj.315.7109.689a

23. Banco de México. Tipos de cambio diarios—(CF102). In: Banco de México [Internet]. 2019 [cited 2019 Nov 28]. Available from: https://www.banxico.org.mx/SieInternet/consultarDirectorioInternetAction.do?sector=6&accion=consultarCuadro&idCuadro=CF102&locale=es

24. Alianza por la salud alimentaria. Los etiquetados frontales de advertencia urgentes para México, muestran ser efectivos en la región de América Latina [Internet]. 2019 [cited 2020 Jan 15]. Available from: https://elpoderdelconsumidor.org/wp-content/uploads/2019/07/b-foro-etiquetado-frontal-efectivo-en-region-d-latinoamerica-vf.pdf

25. 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: 1001–1009. doi: 10.1038/ijo.2010.228 21079620

26. 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: 344–352. doi: 10.1093/heapro/dap032 19815614

27. Sutherland LA, Kaley LA, Fischer L. Guiding Stars: the effect of a nutrition navigation program on consumer purchases at the supermarket. Am J Clin Nutr. 2010;91: 1090S–1094S. doi: 10.3945/ajcn.2010.28450C 20147468

28. Seymour J, Yaroch AL, Serdula M, Blanck HM, Khan LK. Impact of nutrition environmental interventions on point-of-purchase behavior in adults: a review. Prev Med (Baltim). 2004;39: 108–136. doi: 10.1016/j.ypmed.2004.04.002 15313080

29. Sánchez Fermín S. El sector de alimentos y bebidas estima que Ley de Etiquetado costará 5,000 mdp. Expansión. Ciudad de México; Sep 2019 [cited 2020 Jan 28]. Available from: https://expansion.mx/empresas/2019/09/27/el-sector-de-alimentos-y-bebidas-estima-que-ley-de-etiquetado-costara-5-000-mdp.

30. Instituto Nacional de Estadística y Geografía (INEGI), Instituto Naicional al de Salud Pública (INSP), Secretaría de salud (SS). Encuesta Nacional de Salud y Nutrición 2018 Presentación de resultados [Internet]. 2019 [cited 2020 Jan 22]. Available from: https://ensanut.insp.mx/encuestas/ensanut2018/doctos/informes/ensanut_2018_presentacion_resultados.pdf

31. Kanter R, Reyes M, Vandevijvere S, Swinburn B, Corvalán C. Anticipatory effects of the implementation of the Chilean Law of Food Labeling and Advertising on food and beverage product reformulation. Obes Rev. John Wiley & Sons, Ltd; 2019;20: 129–140. doi: 10.1111/obr.12870 31245920

32. Stacey N, Mudara C, Ng SW, van Walbeek C, Hofman K, Edoka I. Sugar-based beverage taxes and beverage prices: Evidence from South Africa’s Health Promotion Levy. Soc Sci Med. Elsevier; 2019;238: 112465. doi: 10.1016/j.socscimed.2019.112465 31472286

33. Public Heath England. Sugar reduction: Report on progress between 2015 and 2018 [Internet]. London; 2019 Sep [cited 2020 Jan 22]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/839756/Sugar_reduction_yr2_progress_report.pdf

34. Ministerio de Salud—Gobierno de Chile. Informe de evaluación de la implementación de la ley sobre composición nutricional de los alimentos y su publicidad [Internet]. 2018 [cited 2020 Feb 15]. Available from: https://www.minsal.cl/wp-content/uploads/2018/05/Informe-Implementación-Ley-20606-febrero-18-1.pdf

35. Sánchez-Romero LM, Canto-Osorio F, González-Morales R, Colchero MA, Ng SW, Ramírez-Palacios P, et al. Association between tax on sugar sweetened beverages and soft drink consumption in adults in Mexico: Open cohort longitudinal analysis of Health Workers Cohort Study. BMJ. 2020;369. doi: 10.1136/bmj.m1311 32376605

36. Colchero MA, Popkin BM, Rivera JA, Ng SW. Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study. BMJ. 2016;352: 1–9. doi: 10.1136/bmj.h6704 26738745


Článek vyšel v časopise

PLOS Medicine


2020 Číslo 7

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…


Kurzy Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Nemáte účet?  Registrujte se

Zapomenuté heslo

Zadejte e-mailovou adresu se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

VIRTUÁLNÍ ČEKÁRNA ČR Jste praktický lékař nebo pediatr? Zapojte se! Jste praktik nebo pediatr? Zapojte se!

×