International Food Policy Research Institute (IFPRI), 1201 Eye St NW, Washington, DC, USA.
Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile.
Int J Behav Nutr Phys Act. 2023 Apr 4;20(1):40. doi: 10.1186/s12966-023-01445-x.
In June 2016, a comprehensive food policy was implemented in Chile that included front-of-package warning labels on key nutrients of concern (total sugars, added saturated fats, sodium, and calories), child-directed food advertisement bans, and school regulations. The policy was implemented in 3 phases from 2016 to 2019 and the primary objective was to improve children's food environments. This study's objective was to assess changes in child and adolescent intake of key nutrients of concern (total sugars, saturated fats, and sodium) at school after the initial implementation of Chile's Law of Food Labeling and Advertisement.
Longitudinal study of 349 children from the Food Environment Chilean Cohort (FECHIC) and 294 adolescents from the Growth and Obesity Cohort Study (GOCS). Data were from single 24-hour dietary recalls collected from 2016 to 2019. Fixed-effects models stratified by school, home, and other locations compared nutrient consumption in each year to consumption at the pre-policy 2016 baseline. Nutrient intakes are expressed as percent of total energy.
Compared to 2016 (pre-policy), total sugars consumed by children at school decreased 4.5 [-8.0, -0.9] percentage points (pp) and 11.8 [-15.4, -8.3] pp in 2018 and 2019 respectively. In 2019, children's saturated fats and sodium intake at school also decreased (1.1 [-1.9, -0.2] pp and 10.3 [-18.1, -2.5] mg/100 kcal respectively). Likewise, in adolescents, total sugars and saturated fats consumed at school decreased in 2018 (5.3 [-8.4, -2.2] pp and 1.5 [-2.7, -0.3] pp respectively). However, consumption of key nutrients of concern at other locations increased after implementation of the policy.
After initial implementation of Chile's Labeling Law, intake of most key nutrients of concern significantly declined at school. However, we found evidence of compensatory behavior in out-of-school settings. Further research is needed to evaluate what other actions are needed to impact overall diets in the long term both at schools and out of school.
2016 年 6 月，智利实施了一项综合食品政策，其中包括对关键营养素（总糖、添加饱和脂肪、钠和卡路里）的包装警告标签、针对儿童的食品广告禁令和学校规定。该政策分三个阶段从 2016 年至 2019 年实施，主要目标是改善儿童的食品环境。本研究的目的是评估智利食品标签和广告法最初实施后，学校儿童和青少年摄入关键营养素（总糖、饱和脂肪和钠）的变化。
对智利食品环境队列研究（FECHIC）中的 349 名儿童和生长与肥胖队列研究（GOCS）中的 294 名青少年进行了纵向研究。数据来自 2016 年至 2019 年期间收集的单次 24 小时膳食回忆。按学校、家庭和其他地点分层的固定效应模型将每年的营养素消耗与政策前 2016 年的基线消耗进行比较。营养素摄入量以总能量的百分比表示。
与 2016 年（政策前）相比，儿童在校摄入的总糖分别减少了 4.5 个百分点[-8.0，-0.9]和 11.8 个百分点[-15.4，-8.3]，分别在 2018 年和 2019 年。2019 年，儿童在校摄入的饱和脂肪和钠也有所减少（分别为 1.1 个百分点[-1.9，-0.2]和 10.3 毫克/100 千卡[-18.1，-2.5]）。同样，在青少年中，2018 年在校摄入的总糖和饱和脂肪也有所减少（分别为 5.3 个百分点[-8.4，-2.2]和 1.5 个百分点[-2.7，-0.3]）。然而，政策实施后，其他地点关键营养素的摄入量有所增加。
智利标签法初步实施后，学校摄入的大多数关键营养素显著下降。然而，我们发现了在学校以外的环境中存在补偿行为的证据。需要进一步研究需要采取哪些其他行动来长期影响学校内外的整体饮食。
