Applying the Chilean front-of-pack warnings to US packaged food

Front-of-pack (FOP) labeling is a critical strategy in public health initiatives aimed at reducing the incidence of diet-related diseases. The Chilean warning labels, introduced in 2016, mark products that are high in sugar, sodium, saturated fats, or calories, with prominent black stop signs. This article presents the findings of a study predicting the impact of implementing such labeling standards in the United States.

Study methods

We obtained the publicly available data from the USDA collected in 2023 and used this dataset as is.
From 429,651 packaged food products identified, we eliminated those that did not have the necessary information to be rated (nutritional table, serving size, etc). This left us with 364,372 products which we evaluated against Chilean FOP labeling regulations to determine which items would require these black stop signs.
We merged food categories to narrow the dataset down to 19 groups, based on USDA food categories.
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Overview of the Chilean FOP Labeling Regulations
The Chilean regulations mandate labeling for products exceeding specified thresholds for sugar, sodium, saturated fats, and calories.
The limits stipulated by law are:

Exemptions: Certain food categories are exempt from the Chilean labeling regulations, such as:

• Food without any added sugar, honey, syrups, sodium and saturated fat.
• Bulk food
• Baby formula
• Supplements and sports foods
• Non-sugar non-calorie sweeteners

Study results

Key findings
71% of products would require at least one black stop sign, for excessive sodium, sugar, saturated fat or calories. That means that only 29% of packaged products currently on US shelves would not have any warning!

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• The most prevalent number of warnings would be 1 or 2 per food item.

• The prevalence of warning signs, from most prevalent to least would be:

• The most common combination of warnings would be
  • High in Calories & High in Sugar on 25% of products
  • High in Calories & High in Saturated Fat on 21% of products

Category-specific results.

• Worst food category for salt (sodium) warnings: Sausages & luncheon meats (86%!); Spices & Herbs; Soups, Sauces & gravies; Snacks.
• Worst food category for sugar warnings: Sweets; Breakfast cereals; Baked products; surprisingly, next come Snacks and Dairy & Egg products.
• Best food category all around: Cereals, Grains & Pasta; Legumes & Legumes products, and Fruit & Vegetable products.
• Worst category globally: Baked Products.
• On average, the products from the following categories will require more than 2 warning labels: Baked Products, Sweets, Breakfast cereals, Snacks

There is a wide spectrum across food categories. The figure below shows the average number of warning signs per food category:

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Discussion

Impact on food manufacturers: reformulation.
Food manufacturers in the U.S. would face immense pressure to reformulate products to avoid black stop signs, as seen in Chile. Reformulation efforts would likely focus on reducing added sugar, sodium, and saturated fat content.
This reformulation would not necessarily trigger an increase in cost to US consumers. In Chile, retail prices did not increase when manufacturers reformulated their products in order to reduce the number of health warnings.

Impact on supermarkets: brand image and shelf space.
Supermarket brands would need to address the high prevalence of black octagon labels on their shelves. Brands with a high incidence of labeled products might suffer reputational damage, leading to decreased consumer trust and loyalty. Supermarkets may need to revise their product placement strategies, prioritizing healthier options to maintain a positive health-conscious image. Beyond brand reputation, this may prove beneficial to consumers, as it would improve healthier products visibility and accessibility, therefore creating a less unhealthy shopping environment.

Impact on consumers: purchaing decisions and nutritional awareness.
The black octagon labels serve as a powerful tool to increase nutritional awareness among consumers. Consumers, confronted with clear health warnings, are likely to alter their purchasing habits. The experience from Chile demonstrated that it lead to significant reductions in the purchase of labeled products, as well as reformulations. Similar trends could be expected in the U.S. In time, this behavior change could ultimately contribute to improved public health outcomes in particular on chronic disease prevalence.

Limitations of the Chilean stop signs.
It is worth keeping in mind that there are limitations to the Chilean warnings regulation:

• Chilean labeling only applies to added ingredients, so food products naturally high in saturated fats (eg. red meat) or in sugar (eg. fruit juice, even 100% pressed juice) would not require a warning, despite the fact that their consumption should be limited as part of a healthy diet.
• The Nutrition profile does not tell the whole story, ultra-processing has shown to pose health risks beyond the nutritional content, and those are not captured by the Chilean warning system seeing that ultra-processing may have specific adverse health impacts (see Kevin Hall's NIH study).

Conclusion

The adoption of Chilean-style black octagon labels in the U.S. could have profound effects across supermarket shelves. Such labeling would apply to 71% of packaged food products, mostly with 1 or 2 warning signs. It would not go unnoticed.

To maintain market shares, manufacturers may be compelled to reformulate products, while supermarkets may adapt their branding and product placement strategies. Consumers would benefit from enhanced nutritional information, and a healthier shopping environment. This would likely lead to healthier purchasing decisions, possibly at no additional cost.

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Article written by Julie Ruelle, Registered Dietitian (US) and Lynne Bouchy, Dietitian student.

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