A citizen perspective on nutritional warnings as front-of-pack labels: insights for the design of accompanying policy measures

Parent Experiences With Warning Labels After Policy Implementation in Uruguay

OBJECTIVE

To explore the perception and experiences of parents of children and adolescents during the first year of the mandatory implementation of nutritional warning labels in Uruguay.

DESIGN

Qualitative research based on semistructured interviews.

SETTING

Montevideo, Uruguay.

PARTICIPANTS

Twenty-eight parents of children and adolescents.

PHENOMENON OF INTEREST

Perception of and experiences with warning labels, a front-of-pack nutrition labeling scheme that has become increasingly popular in Latin America.

ANALYSIS

Content analysis of the transcripts based on a deductive-inductive approach.

RESULTS

Interview transcripts evidenced high awareness, acceptance, and understanding of warning labels among parents of children and adolescents. Most participants reported considering warnings for decision making and changing their purchase decisions because of their implementation, particularly when choosing foods for their children. They reported their children were aware of and understood warnings but did not tend to take them into account when choosing foods.

CONCLUSIONS AND IMPLICATIONS

Results from the present work contribute to the growing body of literature showing the effectiveness of warning labels. Lack of interest or perceived benefits and structural barriers emerged as key motives for not using the warnings when making purchasing decisions, suggesting the need to develop additional strategies to increase policy effectiveness.

Consumers' Perceptions of the Design of Front-of-Package Warning Labels-A Qualitative Study in China

The warning label is identified as a simple front-of-package labeling format that assists consumers in making healthier food choices at the point of purchase. The color and/or shape of the design elements of the packaging labels can influence the understanding and purchase intention outcomes. This study aimed to explore the perceptions of consumers regarding differently designed warning labels (WLs) to identify a possibly suitable warning label design in the Chinese context. Using a qualitative approach, we collected data through 12 focus group discussions consisting of 116 participants residing in 6 provinces. Participants were selected by purposive sampling. Data were coded following inductive thematic analysis and summarized into three themes: (1) perceived preference for the appearance of the WLs, (2) perceived benefits of the WLs, and (3) suggestions for promoting the WLs. Participants preferred the black shield label showing a high content of the nutrients of concern (e.g., sodium, added sugar, and saturated fat) in both Chinese and English. Consumers generally agreed that the WLs were easy to understand and offered a simple method for choosing healthier foods. They anticipated that WLs could encourage the food industry to reformulate their products. Our study results will support the design and facilitate the use of WLs in China.

Improving the understanding of key nutritional elements to support healthier and more informed food choices: The effect of front-of-pack label bundles

OBJECTIVES

In the current open debate at the European level on what would be the best Front-of-Pack Label (FOPL) to support customers' healthier and more informed food choices, little effort has been dedicated to analyzing the potential effects of bundling existing FOPLs. This study aims to compare the effects of consumers' subjective understanding and liking of different types of FOPL bundles.

METHODS

We performed an experimental design by manipulating the FOPLs' scheme, where different types of FOPL bundles were designed according to the "directiveness" of the FOPLs' scheme. A "mixed" bundle was composed of a non-directive label (i.e., NutrInform Battery) and a directive label (i.e., Keyhole), and a "double-directive" bundle was composed of two directive labels (i.e., Nutri-Score and Keyhole). This study was conducted among a sample of 327 Swedish individuals responsible for purchases recruited through international web panel providers.

RESULTS

The results showed that a mixed bundle has been more effective than the double-directive bundle and the single-directive label (i.e., the existing FOPL in the investigated market) in allowing consumers to improve their subjective understanding (in terms of comprehensibility, help-to-shop, and complexity reduction) and liking towards the labels.

CONCLUSIONS

This study extends the current research on bundling in general and on FOPL bundles in particular by providing evidence regarding consumers' subjective understanding and liking of the labels. Additionally, the research provided findings that might be relevant for policymakers by suggesting to investigate bundle of FOPLs to help the consumers' understanding in their process toward healthier and more informed food choices.

Effect of Warning Labels on Consumer Motivation and Intention to Avoid Consuming Processed Foods

Nutritional warnings (NWs) as a front-of-package label were implemented as a public policy aiding consumers with recognizing processed foods with high levels of critical nutrients (sodium, saturated fats, carbohydrates, and calories). However, in spite of this tool being well positioned in consumer decision making, there is little extant knowledge about the relationship between the message sent by NW, nutritional knowledge, consumer motivation, and the intention to avoid consuming processed foods. To understand these dimensions’ relations, a theoretical model was created and subsequently tested through structural equations. We applied a survey to 807 home food purchasing decision makers. The results show that the direct effect of NW messages raises the intention to avoid processed foods, while eating motivation is negative in its direct effect on the same avoidance intention. However, the message sent by NWs had a mediating effect between the intentions to avoid processed food and eating motivation but showed no such effect on nutritional knowledge. This suggests that the message sent by NWs was able to turn negative eating motivation into positive eating motivation to avoid processed foods. In conclusion, NWs help mitigate eating motivations, as well as boost the intention to avoid processed foods.

Obesity in Latin America, a scoping review of public health prevention strategies and an overview of their impact on obesity prevention

OBJECTIVE

To describe the strategies implemented in seventeen Latin American countries for obesity prevention and to provide an overview of their impact.

DESIGN

A thorough search of strategies and their impact was done through an Internet search, governmental webpages, reports and research articles in English, Spanish and Portuguese.

SETTING

Latin America (not including the Caribbean countries).

PARTICIPANTS

Any.

RESULTS

The Ministry of Health is the main oversight for obesity prevention, with six countries having a specific structure for this. Regular obesity monitoring occurs in a few countries, and thirteen countries have a national obesity prevention plan. The main regulations being implemented/designed are front-of-package labelling (sixteen countries), school environment (fifteen countries), school nutrition education (nine countries), promotion of physical activity level (nine countries) and sugar-sweetened beverage tax (eight countries). All countries have dietary guidelines. The main community-based programmes being implemented are school meals (seventeen countries), complementary nutrition (eleven countries), nutrition education (fourteen countries), promotion of physical activity (nine countries) and healthy environments (nine countries). Most of these strategies have not been evaluated. The few with positive results have used a coordinated, multi-disciplinary and multi-sector approach, with legislation and executive-level support.

CONCLUSIONS

Important obesity prevention strategies are being implemented in the seventeen Latin American countries included in the present review. However, few have been evaluated to assess their impact on preventing obesity. This information can help assess that actions can be generalised to other countries within the region and can help inform how to prevent obesity in different settings.

South African consumers' perceptions of front-of-package warning labels on unhealthy foods and drinks

Front-of-package labeling (FOPL) is a policy tool that helps consumers to make informed food choices. South Africa has not yet implemented this labeling system. The aim of this study was therefore to explore adult South African consumers’ perceptions of front-of-package warning labels on foods and non-alcoholic beverages (referred to as drinks in this paper) and their insights into features that could influence the effectiveness of the warning label. Using a qualitative approach, the study purposively selected consumers diversified by urbanization, gender, socioeconomic status, and literacy. We collected data from a total of 113 participants through 12 focus group discussions. Data were systematically coded and divided into five themes namely, positive attitudes toward warning labels, perceived benefits of warning labels, perceived behavior modification, perceived beneficiaries of warning labels, and effective attributes of warning labels. Almost all participants from all socio-economic backgrounds were positive about warning labels, reporting that warning labels concisely and understandably educated them about the nutritional composition of foods. Other perceived advantages were that warning labels warn of health implications, are easily understandable and could benefit child health. Some participants anticipated that warning labels would reduce their purchases of unhealthy foods, while others thought the labels would have no effect on their purchasing habits. Participants found the warning labels attention grabbing and stated that they preferred a black triangle placed on a white background (referred to as a holding strap henceforth), the words “high in” and “warning” in bold and uppercase text, an exclamation mark, and an icon depicting the excessive nutrient. In South Africa warning labels may improve consumer understanding of nutrition information and assist consumers in determining the nutritional quality of packaged foods and drinks.

Analysis of the policy process for the implementation of nutritional warning labels in Uruguay

OBJECTIVE

To analyse the process for the development and implementation of mandatory nutritional warning labels in Uruguay, in order to inform future nutrition policy making and strategic engagement by public health actors.

DESIGN

The study design drew on policy analysis methodology and case study research methodology. Two main sources of information were selected and analysed for the current study: eighteen official documents from the Uruguayan government and 259 news reports, published between June 2017 and February 2021.

SETTING

Uruguay, Latin America.

RESULTS

The Uruguayan Ministry of Public Health led a cross-sectoral working group composed of diverse governmental stakeholders, international organisations and the academia to develop the front-of-package nutrition labelling policy. A robust evidence-based approach, based on rigorous scientific knowledge generated in the country, was followed. However, changes in the systemic governing coalition as a consequence of a change in government led to a delay in the entry into force and changes in the regulation. The food industry was the main opponent to the warning label regulation and relied on widely reported corporate political activities to influence the policy process: information and messaging, legal action, policy substitution, opposition, fragmentation and destabilisation.

CONCLUSIONS

Key insights to inform future policy action in Uruguay and other jurisdictions were derived. Results stressed the importance of an evidence-based approach for policy design and the early engagement with actors from all the political system.

Current use of nutrition facts tables and attitudes towards new red and green front-of-package labels among Israeli consumers

Front-of-package labels (FOPL) are designed to simplify nutrition information and to help consumers make healthier food choices. The Israeli government has implemented new regulations requiring mandatory red warning FOPL for high levels of sodium, sugar, or saturated fats. A voluntary green positive FOPL for products fitting the national nutritional recommendations was concurrently encouraged. In order to characterise adult consumers' current use of Nutrition Facts Tables (NFT) and their attitudes towards the new FOPL, a nationally representative cross-sectional telephone survey was conducted. Most of the 1,042 survey respondents reported frequent NFT use (76.2%) and intentions to purchase fewer red-labelled (81.1%) and more green-labelled products (85.0%). Consumers with higher BMI and lower education expressed higher intentions to use the new FOPL, but not higher current use of NFT. This finding suggests that these high-risk groups, which the new labels are meant to target, may indeed benefit from the new policy.

Health gains through loss frames: Testing the effectiveness of message framing on citizens' use of nutritional warnings

The aim of the present work was twofold: (i) to evaluate the effect of nutritional warnings and health-related packaging cues (nutrient claim and images of natural foods) on consumers' food choices, and (ii) to evaluate the influence of two types of messages (gain-framed and loss-framed) aimed at encouraging the use of such warnings and packaging cues on food choices. A total of 510 participants were recruited using an advertisement on Facebook and Instagram targeted at Uruguayan adult users. Participants were randomly allocated to one of three experimental groups: control (n = 167), loss-framed messages (n = 177) and gain-framed messages (n = 166). Then, they completed a choice-conjoint task involving packages of crackers differing in three variables: nutritional warnings (present vs. absent), nutrient claim (present vs. absent) and images of seeds and wheat (present vs. absent). Warnings were the most relevant package element driving choices, even when participants were not exposed to any type of message. Exposure to loss-framed messages led to changes in the relative importance attached to the package characteristics, whereas gain-framed messages did not. Graphic pieces conveying messages encouraging the use of nutritional warnings by stressing the negative consequences of excessive consumption of sugar, fat, and sodium increased the relative importance attached to nutritional warnings and decreased the relative importance attached to health-related cues (nutrient claims and images of seeds and wheat). These results suggest that public awareness campaigns aimed at encouraging citizens to use nutritional warnings should emphasize the negative health consequences of excessive intake of sugar, fat, and sodium.

A cross-country experimental study on consumers' subjective understanding and liking on front-of-pack nutrition labels

Different Front-of-Pack (FOP) nutritional labels have been implemented in order to increase consumers' awareness of food nutritional quality and encourage healthier choices. However, few studies have analysed the effects of FOPLs on consumers' subjective understanding and liking across different socio-cultural contexts. This study tests the effect that the new enriched informative label NutrInform Battery and the summary label Nutri-Score have on subjective comprehension and liking across 2776 respondents of seven European countries (France, Germany, Greece, Italy, Portugal, Romania and Spain). Main effects regarding socio-demographic differences are also explored according to extant literature and highlighting significant effects of education and income. This study therefore extends the current research on subjective understanding and liking with a cross-country analysis. Findings suggest that NutrInform Battery can help consumers in understanding information in a relevant way, obtaining the highest performance across countries and showing limited impact of socio-cultural differences.

Efficacy of "High in" Nutrient Specific Front of Package Labels-A Retail Experiment with Canadians of Varying Health Literacy Levels

BACKGROUND

In 2018, Health Canada, the Federal department responsible for public health, put forward a regulatory proposal to introduce regulations requiring a "High in" front-of-package label (FOPL) on foods that exceed predetermined thresholds for sodium, sugars, or saturated fat. This study evaluated the efficacy of the proposed FOPL as a quick and easy tool for making food choices that support reduction in the intakes of these nutrients.

METHODS

Consumers (n = 625) of varying health literacy levels (HL) were assigned to control (current labeling with no FOPL) or one of four FOPL designs. They completed six shopping tasks, designed to control for internal motivations. Efficacy was measured with correct product selection and response time (seconds) to make food choices using repeated measures statistical modeling, adjusting for HL, task type, and task order. Eye-tracking and structured interviews were used to gather additional insights about participants' choices.

RESULTS

Overall, FOPL was significantly more effective than current labeling at helping consumers of varying HL levels to identify foods high in nutrients of concern and make healthier food choices. All FOPL were equally effective.

CONCLUSIONS

"High in" FOPL can be effective at helping Canadians of varying HL levels make more informed food choices in relation to sugars, sodium, and saturated fat.

What Dimensions of Risk Perception are Associated with Avoidance of Buying Processed Foods with Warning Labels?

Nutritional Warning Labels (NWLs) inform consumers about processed foods that exceed critical nutrient levels activating the risk perception in consumers. However, this information is limited. The objective was to identify the dimensions of risk perception and to study their associations with avoidance of buying processed foods with warning labels. A survey was applied to 807 decision-makers who choose what to eat at home. The four dimensions of risk perception (performance, financial, physical, and psychological) were identified through exploratory factor analysis. Through a multiple regression model, we determined the dimensions of risk perception and sociodemographic variables that affect the intention to avoid buying processed foods with NWLs. The results show that the performance risk, physical risk, and psychological risk positively affect the intention of avoiding processed foods with NWLs. In addition, the female gender considers NWLs to purchase foods. Nevertheless, the high frequency of consumption and belonging to a lower-income socioeconomic group are barriers to the use of NWLs. In conclusion, NWLs help people to choose processed food that does not impact negatively their food expectations, as well as their mental and physical health. However, health authorities must invest in nutrition education. Specifically, in groups who pay less attention to NWLs. Such groups include people with high daily consumption of processed foods, males, and low-income socioeconomic groups.

Immediate effects of the implementation of nutritional warnings in Uruguay: awareness, self-reported use and increased understanding

OBJECTIVE

To assess the effects of nutritional warnings during the first month after the date of full compliance by the food industry in Uruguay in terms of citizen awareness, self-reported use and ability to understand nutritional information.

DESIGN

The present work encompassed two online studies, conducted before (Study 1) and during the first month after the date of full compliance by the food industry (Study 2). An after-only design was used to assess awareness of the policy, exposure to nutritional warnings on food packages and self-reported use of warnings for making purchase decisions in Study 2. An after-only with control group experimental design was used to assess the effect of nutritional warnings on understanding of nutrition information in Studies 1 and 2.

SETTING

Uruguay, one of the Latin American countries, that has recently implemented nutritional warnings.

PARTICIPANTS

A non-probabilistic sample of 1772 participants was recruited using Facebook advertisements targeted at Uruguayan adult users.

RESULTS

High awareness and self-reported use of nutritional warnings during the first month after the date of full compliance in Uruguay were observed. In addition, the before and after comparison showed that the implementation of warnings increased citizens' ability to use nutritional information to compare products and to identify products with excessive content of sugar, fat, saturated fat and sodium.

CONCLUSIONS

The current study confirms results from experimental studies and provides additional evidence to support the implementation of nutritional warnings as one of the public policies that can contribute to tackle obesity and non-communicable diseases.

[Food industry arguments against front-of-package nutrition labels in UruguayArgumentos da indústria alimentícia contra a rotulagem frontal de advertência nutricional no Uruguai]

Objetivo.

Identificar los argumentos de la industria alimentaria en contra del etiquetado frontal de advertenciasnutricionales en Uruguay.

Métodos.

Se realizó un análisis de contenido de los comentarios de la industria alimentaria recibidos durante la consulta pública implementada durante el proceso de diseño del decreto que reglamenta la inclusión de rotulación nutricional frontal basada en advertencias en Uruguay mediante una codificación inductiva.

Resultados.

La mayoría de los comentarios manifestaron la preocupación por la elevada prevalencia de obesidad y enfermedades no transmisibles en el país y destacaron el compromiso con la implementación de acciones que contribuyan a combatir esta problemática de salud. Sin embargo, 81% de los comentarios planteó desacuerdo con la propuesta de decreto elevada a consulta pública y realizó críticas generales sobre su validez. El contenido de los comentarios se relacionó con siete dimensiones: falta de justificación de la medida, violación de compromisos internacionales, críticas al sistema de advertencias, discriminación a alimentos industrializados envasados, críticas al modelo de perfil de nutrientes, otras críticas a aspectos específicos del proyecto de decreto y efectos económicos negativos. En cada dimensión se discute la pertinencia y consistencia técnica y normativa de los contenidos vertidos por los representantes de la industria.

Conclusiones.

Bajo un aparente acuerdo con la necesidad de adoptar medidas, se evidenció, sin embargo, una fuerte oposición a la política y en particular al sistema de advertencias por parte de la industria alimentaria. Los resultados del análisis aportan insumos para facilitar el proceso de implementación de regulaciones similares en otros países.

A randomized controlled trial examining consumers' perceptions and opinions on using different versions of a FoodFlip© smartphone application for delivery of nutrition information

Background

Food labelling is a common intervention to improve diets, where the back-of-pack Nutrition Information Panel (or Nutrition Facts table (NFt)) provides comprehensive nutrition information on food packages. However, many consumers find it difficult and time-consuming to identify healthier foods using the NFt. As a result, different interpretative nutrition rating systems (INRS) may enable healthier food choices and it is essential that consumers have the tools to allow for easily accessible nutrition information. The objective of this study was to examine consumers’ perceptions of different (INRS) for delivery of nutrition information using different versions of a smartphone app, FoodFlip©.

Methods

This study was part of a larger randomized controlled trial examining consumer perceptions of different INRS on food products. A nationally representative commercial sample of 2008 Canadians were randomized to one of four INRS intervention groups: 1) traffic light, 2) health star rating, 3) ‘high-in’ warning labels or 4) no INRS (NFt only; control) and asked to scan or enter 20 products into FoodFlip© from a list of food products provided to them with varying levels of healthfulness. After completing the app task, participants were asked a series of 7-point Likert-scale and open-ended questions to provide opinions on the usability and functionality of the app.

Results

Of the survey sample of 1997 participants, 95% (n = 1907) completed the app task, with similar number of participants in each treatment group. The mean age was 40 ± 12 years with no differences in sociodemographic characteristics between treatment groups. The health star rating ranked significantly lower in comparison to the other treatment groups in terms of usefulness (OR, 95% CI -0.67, 0.52–0.85), believability (0.59, 0.46–0.75), and understanding (0.55, 0.44–0.71) (p < 0.001). The health star rating (1.20, 0.94–1.53) and control (NFt) (1,1,1) ranked significantly lower than the traffic light or the ‘high-in’ warning labels for their ability to compare the healthfulness of products (p < 0.001).

Conclusion

This study demonstrated Canadian consumers’ preference for a nutrient-specific system (i.e. traffic light or ‘high-in’ warning labels). The app, which was liked by majority of the participants for its functionality and usability, has the potential to support healthy dietary decision making and may also encourage reformulation.

Trial registration

NCT03290118 (Clinicaltrials.gov).

How Can We Motivate People to Use Nutritional Warnings in Decision Making? Citizen Co-Created Insights for the Development of Communication Campaigns

Nutritional warnings are intended to enable citizens to make informed choice by clearly identifying food products with excessive content of nutrients associated with noncommunicable diseases. The efficacy of this public policy is expected to improve if accompanied by communication campaigns that raise awareness of the existence of nutritional warnings, as well as encourage citizens to take them into account in decision making. Because ordinary citizens have been shown to generate significantly more creative and valuable ideas than advanced users and professional developers, the aim of the present work was to obtain qualitative, citizen co-created insights for the design of a communication campaign. An online study was conducted with 518 Uruguayan citizens, recruited using a Facebook advertisement. Participants were asked to answer a series of open-ended questions about how they would encourage other people to use the warnings for making their food choices, as well as the key contents of a communication campaign. Responses were analyzed using content analysis. Results showed that, according to the participants’ accounts, an effective public awareness campaign aimed at promoting the use of nutritional warnings in decision making should include three main concepts: (a) position warnings as a cue to action for improving eating habits by enabling informed choices; (b) emphasize the benefits of using the warnings for avoiding consumption of unhealthy food and, consequently, achieving a healthier diet and an improvement in health status and quality of life; and (c) increase the perceived susceptibility and severity of the negative consequences of consumption of foods with excessive content of sugar, fat, and sodium. A communication campaign based on these key concepts could contribute to increasing the efficacy of nutritional warnings.

Does message framing matter for promoting the use of nutritional warnings in decision making?

Objective:

To evaluate the impact of message framing on attitudes towards messages aimed at promoting the use of nutritional warnings, behavioural intention and actual behaviour, evaluated through visual attention to nutritional warnings and the choice of a snack product during a real choice task.

Design:

Following a between-subjects design, participants were exposed to loss-framed nutrition messages, gain-framed nutrition messages or non-nutrition-related messages (control group). After evaluating the messages, participants were asked to select a snack product as a compensation for their participation. The experiment was conducted using an eye tracker.

Setting:

Montevideo (Uruguay).

Participants:

Convenience sample of 201 people (18–51 years old, 58 % female).

Results:

The average percentage of participants who fixated their gaze on the nutritional warnings during the choice task was slightly but significantly higher for participants who attended to nutrition messages (regardless of their framing) compared with the control group. Participants who attended to loss-framed messages fixated their gaze on the warnings for the longest period of time. In addition, the healthfulness of the snack choices was higher for participants exposed to nutrition-related messages compared with the control group.

Conclusions:

Results from the present work suggest that nutrition messages aimed at increasing awareness of nutritional warnings may increase consumers’ visual attention and encourage more heathful choices. The framing of the messages only had a minor effect on their efficacy.

Consumers' opinions on warning labels on food packages: A qualitative study in Brazil

This study aimed to assess consumers’ uses of and opinions on the current Brazilian food label and their reaction to the introduction of a front-of-package warning label. We conducted 12 focus groups among a diverse sample of adult consumers, to broadly assess: (1) uses of and perceptions about the current food label, and (2) opinions about implementing a front-of-package warning label to guide food purchases. Data was analyzed with a triangulation of researchers using an exploratory content analysis, which allowed codes to emerge from the data. The frequency of codes across focus groups was compared by gender and socioeconomic status to explore differences by these sociodemographic factors. Codes were divided into six main themes: (1) “Reasons for using food labels”; (2) “Barriers to using food labels”; (3) “Requirements for a new label”; (4) “Perceived influence on consumption behaviors”; (5) “Perceived influence on child behaviors”; and (6) “Perceptions of the food manufacturers using of warning labels”. Participants used food labels to check nutrient content and ingredient information but the format of these labels and the technicality of the content displayed often made the information inaccessible, particularly for those with low socioeconomic status. Most participants were supportive of the display of front-of-package warning labels on products and considered them useful to inform purchases. Women believed that they and their children would reduce the consumption of foods with front-of-package warning labels, while men reported more polarity in their intentions. For men and their children, front-of-package warning labels would result in either stopping food intake entirely or continued consumption without changes to the amount. The study results highlight the potential of front-of-package warning labels to support healthier behaviors in both consumers and their children.

The Food Supply Prior to the Implementation of the Chilean Law of Food Labeling and Advertising

This study aimed to evaluate the composition of the food supply ahead of the implementation of the Chilean Law of Food Labeling and Advertising (Law 20.606) in June 2016. The INFORMAS (International Network for Food and Obesity/Non-communicable Diseases (NCDs) Research, Monitoring and Action Support) framework for monitoring the composition of the food supply was used. The Law’s initial (2016) and final (2019) limits were used to evaluate if foods would receive a “High in” warning for Calories, Sodium, Sugars and/or Saturated Fats (initial/final, solids: >350/275 kcal; >800/400 mg; >22.5/10 g; >6/4 g; liquids: >100/70 kcal; >100/100 mg; >6/5 g; >3/3 g respectively). Foods were excluded if they required reconstitution, had missing information or if total labeled energy was estimated as incorrect (n = 942). In February 2015 and 2016, fieldworkers photographed a purposeful sample of packaged food and beverage products (n = 5421 and n = 5479) from 6 different supermarkets in Santiago, Chile. Seven percent of foods had no added critical nutrients (n = 720). Two-thirds of products had critical nutrients exceeding at least one initial limit indicative of a “high in” warning. Under the final phase limits, only 17% of foods would have zero warning labels. By 2019, 10 of the 17 food and beverage categories studied are predicted to have less than half of their products without a high in sodium warning label. While 8 of the 17 categories studied are predicted to have less than half their products without a high in total sugars or a high in total calories warning label, respectively; while even fewer food and beverage categories are predicted to be without a high in saturated fat warning label. Most products will have to be reformulated to avoid at least one front-of-package warning label.