Lancet study links Chile food reforms to lower childhood obesity risk

Chile’s package of food labelling, school food and marketing reforms has been linked to a lower risk of school-age children being overweight or living with obesity, according to new research published in The Lancet.

Researchers found children aged four to six were less likely to be overweight or living with obesity within 18 months of the introduction of Chile’s Food Labelling and Advertising Law (FLAL). The study analysed data from more than 300,000 schoolchildren and provides what researchers describe as the first real-world evidence to plausibly show that a national package of food policies can reduce childhood obesity risk.

Introduced in 2016, FLAL targets foods and drinks high in sugar, saturated fat, salt or calories through mandatory front-of-pack warning labels in the form of black ocatagons, restrictions on sales in schools and limits on marketing directed at children.

These results offer strong evidence for policymakers around the world. They support mandatory front-of-pack nutrition warning labels, restrictions on unhealthy food in schools, and marketing bans as effective, practical ways to tackle the childhood obesity epidemic.”

Professor Guillermo Paraje, Professor of Economics at Universidad Adolfo Ibáñez Business School in Chile

The study found girls exposed to the policy for 18 months were 2.9 percent less likely to be overweight or have obesity, while boys were 2.4 percent less likely. Researchers also identified a plausible causal impact after just six months of implementation, with girls showing a 1.9 percent lower risk of overweight or obesity and boys a 2.2 percent lower risk.

Chile introduced the legislation in response to some of the highest childhood overweight and obesity rates in the world. The findings add to evidence that coordinated food policy measures may have a greater impact than individual interventions alone, such as sugar taxes on soft drinks.

Study strengthens case for food reforms

Professor Guillermo Paraje, Professor of Economics at Universidad Adolfo Ibáñez Business School in Chile, said the findings mark the first study to plausibly demonstrate that a package of food policies can reduce early childhood overweight and obesity risk at a national level.

“These results offer strong evidence for policymakers around the world. They support mandatory front-of-pack nutrition warning labels, restrictions on unhealthy food in schools, and marketing bans as effective, practical ways to tackle the childhood obesity epidemic,” he said.

The research assessed only the first phase of FLAL. Chile tightened nutrient thresholds for sugar, saturated fat, salt and calories in 2018 and 2019 through subsequent phases of the law, meaning the study does not capture their impact.

Dr Nieves Valdes, Associate Professor of Economics at Universidad Adolfo Ibáñez Business School, added: “Although the reduction in obesity and overweight risk among young school children may seem modest, it is likely that the further tightening of the law in later years will have increased the impact, especially given evidence that there was a greater drop in sales of labelled food products during Phase 2 of the FLAL compared to Phase 1.”

Valdes added that even modest reductions in childhood weight can deliver meaningful long-term health benefits because of the strong links between childhood obesity and later risks of obesity, diabetes, hypertension and cardiovascular disease. Evidence also suggests early prevention can substantially reduce those risks.

In a linked comment, Professor Simone Pettigrew and Dr Daisy Coyle of The George Institute for Global Health in Australia said the findings strengthen the case for governments to move beyond individual policy measures and adopt broader strategies to improve food environments. They highlighted mandatory warning labels, marketing restrictions and school food standards as measures capable of delivering meaningful public health outcomes.